CPR risk for rescuer

Persons doing defib get electrical exposure in excess of recommended levels

A CADAVER study identifies indicates that medical and paramedical personnel doing cardiopulmonary resuscitation (CPR) may be exposing themselves to some risks with hands-on defibrillation.

Hands-on defibrillation helps reduce long pauses in cardiac compressions during CPR. But thre rescuers do not realize that while doing this technique, they are increasing their exposure to electric shock.

Lemkin DL et al. evaluated this risk by obtaining voltage measurements while rescuers performed defibrillation on cadavers. (Resuscitation 2014 June 30)

The researchers found that the persons doing the defib were exposed to between 200 and 827 volts, depending on the cadaver and electrode location; and received between 1 and 8 joules of electrical energy. This amount exceeds recommended exposure levels.

Commenting on this study, Kristi L. Koenig, MD, FACEP, FIFEM wrote in Journal Watch that the electrical exposure may have been underestimated, because the study participants used nitrile gloves, which can somehow reduce electrical transmission. “Future protective equipment such as insulating gloves, gurneys, and railings may change protocols,” she said. “However, for now, hands-on defibrillation should be considered unsafe. We should follow current guidelines that focus on high-quality chest compressions and minimizing pauses, but chest compressions and all other patient contact should cease during defibrillation,” she recommended.

VitalSigns Issue 65 Vol. 3, July 1-31, 2014

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