Is external defibrillation an electric threat for bystanders?

Area of Science:

• Emergency Medicine
• Biomedical Engineering
• Cardiology

Background:

• Safety protocols for defibrillation and cardioversion are stringent.
• The risks to bystanders and rescuers from these procedures are seldom studied.
• Current research explores continuous chest compressions during defibrillation to improve cardiac arrest outcomes.

Purpose of the Study:

• To review reported incidents of electric shocks to individuals other than patients during defibrillation/cardioversion.
• To discuss the underlying biomedical principles related to these adverse events.
• To assess the safety of external electric therapy for non-patients.

Main Methods:

• A systematic literature search was conducted across medical databases.
• Reference lists of relevant articles were manually reviewed.
• Analysis of reported adverse events involving defibrillation/cardioversion.

Main Results:

• Twenty-nine adverse events were identified in the literature.
• Causes included device misuse (7), malfunction (3), training (4), and resuscitation efforts (15).
• Reported injuries were typically minor (tingling, burns), with no life-threatening outcomes for rescuers/bystanders; direct shocks can be lethal.

Conclusions:

• External electric therapy appears safer than previously assumed, particularly with modern self-adhesive electrodes.
• Further rigorous clinical trials are essential before revising current safety guidelines.
• While generally safe for unintended exposure, direct application to a healthy individual poses a lethal risk.