title: An innovative approach to medical control: semiautomatic defibrillators with solid-state memory modules for recording cardiac arrest events.
abstract: We evaluated the use of microprocessor-based memory modules incorporated into automatic external defibrillators. These solid-state modules store information about each clinical use, including selected segments of the ECG rhythm and notations on defibrillator operation. A playback unit provides annotated printouts of the recorded information. The purpose of our evaluation was to determine whether this memory module could adequately support medical control "run-reviews" when compared with dualfunction (voice and ECG) tape recordings. A total of 41 resuscitation attempts by emergency medical technicians trained to defibrillate (EMT-Ds) were evaluated in five preselected performance areas: defibrillation skills, command and communication at the scene, patient assessment and support, safety, and speed. When performance was reviewed using the tape recordings, the average EMT-D performance score was 16.2 (maximum, 20); when reviewed using the printouts from the medical control modules, the average score, 7.2, was significantly lower (P less than .01). The lower scores with the medical control module occurred because not all five areas of skill could be evaluated adequately by the memory module approach. Assessment of the areas of communication/command at the scene, patient assessment/support, and safety required verbal tape recordings. The medical control module appeared superior to the tape recordings at providing a quick, convenient, and accurate evaluation of rhythm assessment, shock decisions, time intervals, and defibrillator performance. They make several features of medical control review easier and more convenient, and may encourage implementation of early defibrillation programs. We conclude, however, that medical control modules cannot replace on-scene tape recordings for adequate medical control of EMT-D programs.
authors.affiliation: Center for Evaluation of Emergency Medical Services, King County, Department of Public Health, Seattle, Washington.
authors.forename: R O
authors.initials: RO
authors.lastname: Cummins
authors.forename: D
authors.initials: D
authors.lastname: Austin
authors.forename: J R
authors.initials: JR
authors.lastname: Graves
authors.forename: C
authors.initials: C
authors.lastname: Hambly
mesh_terms: D001331:Automation; D004554:Electric Countershock / Q000295:instrumentation* / Q000379:methods; D004634:Emergency Medical Technicians / Q000193:education; D005069:Evaluation Studies as Topic; D006801:Humans; D012151:Resuscitation / Q000193:education; D013637:Tape Recording; D014831:Voice; D014861:Washington