Achieving safe hands-on defibrillation using electrical safety gloves--a clinical evaluation

Area of Science:

• Cardiology
• Medical Devices
• Patient Safety

Background:

• Hands-on defibrillation (HOD) aims to minimize interruptions in chest compressions during resuscitation.
• Uninterrupted compressions during defibrillation may enhance resuscitation success rates.
• Assessing rescuer safety during HOD is crucial for widespread adoption.

Purpose of the Study:

• To evaluate the safety of electrical insulating gloves for rescuers during HOD.
• To quantify rescuer leakage current in a simulated 'worst-case' electrical scenario.

Main Methods:

• Measurements of leakage current were taken during anterolateral defibrillation in patients undergoing elective cardioversion.
• Rescuers wore Class 1 electrical insulating gloves and maintained firm contact (20 kgf) with the patient.
• A simulated inadvertent contact was introduced via an additional wired connection between the rescuer and patient.

Main Results:

• Data from 61 shocks across 43 patients were analyzed.
• The median leakage current was 20.0 μA (range: 2.0-38.5 μA).
• Shocks delivered at 360 J resulted in a median leakage current of 27.0 μA (range: 14.3-38.5 μA).

Conclusions:

• Class 1 electrical insulating gloves significantly reduce rescuer leakage current during HOD.
• Leakage current remains well below the 1 mA safe threshold.
• HOD is deemed safe when using these gloves, even with a single additional point of contact.