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Desfibrilación manual: un análisis del flujo de corriente eléctrica a través de los socorristas en contacto directo

Michael S Lloyd¹, Brian Heeke, Paul F Walter

¹Emory University Hospital, Cardiac Electrophysiology Department, 1364 Clifton Rd NE, Suite F424, Atlanta, GA 30322, USA. michael.lloyd@emoryhealthcare.org

|May 7, 2008

Resumen

Los rescatistas que realizaban compresiones torácicas durante la desfibrilación experimentaron una corriente de fuga mínima, por debajo de los estándares de seguridad. Esto soporta compresiones ininterrumpidas para mejorar los resultados de la reanimación.

Área de la Ciencia:

Cardiología Cardiología.
Medicina de emergencia Medicina de emergencia.
Ingeniería Biomédica Ingeniería Biomédica.

Sus antecedentes:

Las interrupciones en las compresiones torácicas disminuyen la efectividad de la reanimación durante el paro cardíaco.
Los períodos de descanso son necesarios para la desfibrilación, creando pausas inevitables en las compresiones.
La seguridad de los socorristas en contacto con pacientes durante la desfibrilación no está bien establecida.

Objetivo del estudio:

Para evaluar la seguridad de los rescatistas que mantienen las compresiones torácicas durante la desfibrilación externa bifásica.
Para cuantificar la tensión de fuga y la exposición actual a los socorristas durante los eventos de desfibrilación.

Principales métodos:

Se midió la tensión de fuga y la corriente en los rescatistas simulados durante las compresiones torácicas en 43 pacientes que recibieron descargas bifásicas.
Simuló una trayectoria de corriente de retorno en el peor de los casos conectando un electrodo del muslo en el rescatista a un electrodo del paciente.
Evaluó la percepción de choque del rescatista y midió las diferencias de potencial pico y la corriente de fuga promedio.

Principales resultados:

Los rescatistas no percibieron ninguna sacudida.
Las diferencias de potenciales máximos oscilaron entre 0,28 y 14 V (media de 5,8 V).
La corriente de fuga promedio fue de 283 microA, por debajo de los límites de seguridad recomendados.

Conclusiones:

Los rescatistas que realizan compresiones torácicas durante la desfibrilación están expuestos a niveles bajos y seguros de corriente de fuga.
Las compresiones torácicas ininterrumpidas durante la desfibrilación son factibles.
Esta práctica puede mejorar la eficacia de la desfibrilación y la resucitación cardiocerebral.

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