Abstract 312: "Stand Clear" Belongs to the Past: A Solution for Safe Hands-on Defibrillation

Abstract

Introduction: Interruptions to chest compressions during defibrillation reduce the chances of subsequent ROSC and successful defibrillation. Safe hands-on defibrillation (HOD) will allow uninterrupted chest compression during defibrillation and may improve resuscitation success. We tested the safety of rescuer contact with the patient (at the waist) whilst additionally wearing electrical insulating gloves during clinical defibrillation; a worst case scenario. Materials and Method: Leakage current flowing from the patient to the ‘rescuer’ during defibrillation of patients undergoing elective defibrillation was measured. The ‘rescuer’ remained in contact with the patient during defibrillation, wearing Class 1 electrical insulating gloves while simulating an inadvertent contact with the patient, through an additional wired contact between rescuer’s waist and patient. The results were compared with an international safety threshold of 1 mA. Results: Data from 67 shocks of variable biphasic energy from a total of 50 patients was recorded. The median leakage current from all defibrillations was 30 μA, (range: 7 - 164). Of the 34 of the shocks delivered at 360J the median leakage current was 62 μA (range: 13 - 164), all below the safety threshold of 1 mA. Conclusion: This study demonstrates that leakage current through the rescuer is within a safe threshold to allow hands-on defibrillation when using electrically insulated gloves and in the presence of an additional point of contact with the patient