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Related Experiment Videos

Do pulse checks delay semiautomatic defibrillation by EMT-defibrillators?

J E Gough1, A R Cotten, L H Brown

  • 1Department of Emergency Medicine, University Medical Center of Eastern Carolina, Pitt County, Greenville, North Carolina, USA.

The Journal of Emergency Medicine
|May 1, 1995
PubMed
Summary

Pulse checks by emergency medical technicians (EMTs) delay defibrillation for cardiac arrest patients. While statistically significant, the 2.7-second delay may not be clinically relevant, suggesting pulse checks could be reconsidered.

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Area of Science:

  • Emergency Medicine
  • Cardiology
  • Clinical Practice Guidelines

Background:

  • Current Advanced Cardiac Life Support (ACLS) guidelines from the American Heart Association (AHA) omit pulse checks between initial defibrillations for pulseless ventricular tachycardia/fibrillation.
  • The AHA posits that pulse checks unnecessarily delay critical defibrillation.
  • This study investigates the impact of pulse checks on defibrillation timing by EMT-Defibrillators (EMT-Ds).

Purpose of the Study:

  • To quantify the time delay introduced by pulse checks performed by EMT-Ds between successive defibrillations.
  • To evaluate the clinical significance of any observed delay in the context of emergency cardiac care.

Main Methods:

  • Twenty-seven EMT-Ds participated in a study using a semiautomatic external defibrillator (SAED).

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  • Two test scenarios were employed: one with pulse checks after the first and second defibrillations, and one without.
  • The time interval between the first and third defibrillation was meticulously recorded.

    • Main Results:

    • The mean time to deliver three defibrillations was 60.2 ± 6.2 seconds with pulse checks.
    • Without pulse checks, the mean time was 57.5 ± 4.6 seconds.
    • A statistically significant delay of 2.7 ± 5.9 seconds was observed when pulse checks were performed (P = 0.026).

    Conclusions:

    • Pulse checks by EMT-Ds demonstrably delay the administration of defibrillation.
    • Despite statistical significance, the clinical impact of this 2.7-second delay warrants consideration.
    • Reinstatement of pulse checks within AHA guidelines may be warranted, pending further clinical significance evaluation.