Inappropriate electrical countershocks by an automated external defibrillator.
A 79-year-old man who was in normal sinus rhythm with a palpable pulse was inappropriately shocked twice by a fully automated external defibrillator. The second shock resulted in ventricular tachycardia. The device then countershocked a third time, restoring normal sinus rhythm. The problem occurred primarily because the rescuers did not follow the device's instructions warning against applying the device in analysis mode to a patient with a palpable pulse, and they attempted to analyze the rhythm in a moving vehicle. Motion artifact and T waves that were relatively tall compared with the QRS amplitude were misinterpreted as ventricular fibrillation by the device. This example of inappropriate countershocks delivered by rescuers using a fully automated device illustrates the importance of proper training and continuing education.
Ornato
J P
JP
Internal Medicine Section of Emergency Medical Services, Medical College of Virginia, Richmond.
Shipley
J
J
Powell
R G
RG
Racht
E M
EM
D000368:Aged; D004554:Electric Countershock / Q000009:adverse effects* / Q000295:instrumentation; D004562:Electrocardiography; D006801:Humans; D008297:Male; D017180:Tachycardia, Ventricular / Q000209:etiology*