Does paddle force applied during defibrillation meet advanced life support guidelines of the European Resuscitation Council?
OBJECTIVE
to determine whether paddle force applied during defibrillation meets the 12 kg (approximately 120 N) force recommended by the advanced life support (ALS) guidelines of the European Resuscitation Council (ERC).


METHODS
an adult mannequin was "defibrillated" using standard defibrillation paddles instrumented to measure paddle force. Paddle force was recorded at the time the discharge buttons on the paddle handles were depressed.


RESULTS
54 doctors and nurses performed simulated defibrillation on a mannequin. Median sternal paddle force was 60.6 N (range 26.1-132.8 N) and median apical paddle force was 59.5 N (range 18.6-118.5 N). Only 3/54 operators (5.6%) applied sternal paddle force equal to or in excess of ERC recommendations. No operator applied apical paddle force equal to or in excess of ERC recommendations.


CONCLUSIONS
force applied to defibrillation paddles does not meet guidelines of the European Resuscitation Council. Greater emphasis during advanced life support training should be placed on the importance of firm paddle force during defibrillation.
Shackleton Departments of Anaesthetics and Department of Medical Physics and Bioengineering, Southampton University Hospital, NHS Trust Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK. cddeakin@hotmail.com
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Deakin
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Petley
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Cardan
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Clewlow
D000328:Adult; D022561:Advanced Cardiac Life Support / Q000379:methods*; D004554:Electric Countershock / Q000379:methods / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D008955:Models, Cardiovascular; D017410:Practice Guidelines as Topic; D012044:Regression Analysis