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Hands-On Defibrillation

Updated: Nov 7, 2023

“ALL CLEAR” has always been part of our Defibrillation safety ritual. Is this about to change??

Defibrillation has lots of life-saving potential and has the potential to cause harm to HCPs and patients when we delay defibrillation. Remember that for every minute we delay defibrillation, the chances of success for our patients diminish by 7-10% per minute. AHA recommends minimizing hands-off time and that our Chest Compression Fraction (CCF) goal should be aimed at ≥80% to ensure good cerebral and coronary perfusion.

Studies were conducted where Chest compressions were continued without pausing for defibrillation to maximize CCF, but the safety of these techniques is unproven.

One study concluded that hands-on defibrillation has the potential to be performed safely if the rescuer uses appropriate electrical insulating barriers such as polyethylene gloves or class 1 electrical insulating gloves. The safety profile of nitrile gloves was unclear. Since shock detection was used as a proxy for safety, additional investigation is warranted before hands-on defibrillation becomes standard practice.

I do not feel there is sufficient evidence to perform hands-on defibrillation safely at this time, and more research is needed, but I agree that minimizing peri-shock pauses in CPR is a must.

-Deakin CD, Thomsen JE, Løfgren B, Petley GW. Achieving safe hands-on defibrillation using electrical safety gloves--a clinical evaluation. Resuscitation. 2015 May;90:163-7. doi: 10.1016/j.resuscitation.2014.12.028. Epub 2015 Feb 26. PMID: 25725295.

-Sullivan JL, Chapman FW. Will medical examination gloves protect rescuers from defibrillation voltages during hands-on defibrillation? Resuscitation. 2012 Dec;83(12):1467-72. doi: 10.1016/j.resuscitation.2012.07.031. Epub 2012 Aug 25. PMID: 22925991.

Disclaimer: This post is for educational purposes and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.


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