Self-adhesive preapplied electrode pads for defibrillation and cardioversion

Kerber, Richard E.; Martins, James B.; Kelly, Kevin J.; Ferguson, David W.; Kouba, Craig; Jensen, Susan R.; Newman, Bill; Parke, Jeffrey D.; Kieso, Robert A.; Melton, Jeffrey

doi:10.1016/s0735-1097(84)80258-2

Cited by 89 publications

(27 citation statements)

References 11 publications

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“…The electrodes used were either standard hand-held electrode paddles or self- 12 When the defibrillator was actually discharged, the selected and delivered energy, peak current flow, and the patient's transthoracic impedance during the discharge were monitored by a microprocessor and annotated on a hard copy electrocardiographic writeout. '3…”

Section: Methodsmentioning

confidence: 99%

Energy, current, and success in defibrillation and cardioversion: clinical studies using an automated impedance-based method of energy adjustment.

et al. 1988

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TO DEFIBRILLATE or cardiovert, passage of sufficient electrical current through the heart must occur. 1-3 However, the optimal currents for the termination of various arrhythmias have not previously been defined. In traditional clinical practice, the operator selects an energy arbitrarily; the American Heart Association at present recommends an initial shock energy of 200 J to terminate ventricular fibrillation.4 However, the actual current flow is determined not only by the selected energy but also by the transthoracic impedance. If the transthoracic impedance is high, low 1038energy may generate inadequate current to achieve defibrillation. For example, we previously found that defibrillation was achieved by only 20% of 100 J shocks given to patients with very high ( > 97 Q) transthoracic impedance, as opposed to a 70% success rate of 100 J shocks given to patients with low or average impedance.5 Although this problem could be overcome by selecting higher shock energies, excessive energy and current may cause morphologic and functional damage.6-9 Thus, low energies and current, when appropriate, are preferable. In view of these considerations, a reasonable first approach would be to base energy selection on transthoracic impedance: a relatively low energy, 100 J, should achieve defibrillation or cardioversion in most patients with low impedance, whereas higher energies, 200 J or more, are needed for high-impedance patients. We therefore devised an impedance-based energy

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Section: Methodsmentioning

confidence: 99%

Energy, current, and success in defibrillation and cardioversion: clinical studies using an automated impedance-based method of energy adjustment.

et al. 1988

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“…Five studies (LOE 3 57,58 ; LOE 5 59 -61 ) showed that TTI was not affected by electrode composition. The end point for all of these studies was TTI, and no studies involved outcomes following cardiac arrest.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 6: Defibrillation

Sunde¹,

Deakin²,

Hazinski³

et al. 2010

Circulation

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“…These pads have been previously shown to be an effective alternative to paddle defibrillation in the hospital setting. 18 One pad is placed over the apex, the other on the upper chest just to the right of the sternum. Excellent artifact-free ECG tracings resulted from this pathway.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of an automated external defibrillator in the management of out-of-hospital cardiac arrest: validation of the diagnostic algorithm and initial clinical experience in a rural environment.

Stults¹,

Brown²,

Kerber³

1986

Circulation

156

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Automatic external defibrillators (AEDs) may have advantages over manual defibrillation in managing prehospital cardiac arrest, particularly in rural communities. We conducted a two-part evaluation of a commercially available AED. We first established the diagnostic accuracy of the AED's rhythm recognition algorithm by challenging it with 205 cardiac arrest rhythms previously recorded from actual patients in the field. The AED demonstrated 100% specificity and 92% sensitivity for ventricular fibrillation (VF) in this nonclinical setting. We then compared the clinical efficacy of AEDs in 18 small communities (study group) with that of manual defibrillation in 18 additional communities (control group) of similar size. Ambulance technicians using manual defibrillators correctly diagnosed VF more frequently than the AEDs (98% vs 83%; p < .025). Specificity for VF was similar in the two groups (100% for AEDs vs 94% for technicians; p > .10). AEDs were able to deliver shocks more quickly than was possible with the manual defibrillators (1.56 vs 2.77 min; p < .001). The ability of the AEDs to terminate VF was excellent, converting VF in 28 of 29 (97%) patients to some other rhythm compared with only 37 of 53 (70%) patients in the control group (p < .01). Hospital admission and discharge rates were similar for the two groups. Ten of the 35 (29%) patients managed with AEDs achieved admission and six (17%) were ultimately discharged. In the control group 17 of 53 (33%) patients with VF were admitted and seven (13%) were discharged (p > .75). AEDs are an effective alternative to manual defibrillation in small communities.Circulation 73, No. 4, 701-709, 1986. CARDIOVASCULAR DISEASE continues to be the leading cause of death in the United States, particularly sudden cardiac death occurring outside of the hospital.

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Self-adhesive preapplied electrode pads for defibrillation and cardioversion

Cited by 89 publications

References 11 publications

Energy, current, and success in defibrillation and cardioversion: clinical studies using an automated impedance-based method of energy adjustment.

Energy, current, and success in defibrillation and cardioversion: clinical studies using an automated impedance-based method of energy adjustment.

Part 6: Defibrillation

Efficacy of an automated external defibrillator in the management of out-of-hospital cardiac arrest: validation of the diagnostic algorithm and initial clinical experience in a rural environment.

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