Is optimal paddle force applied during paediatric external defibrillation?
BACKGROUND
Optimal paddle force minimises transthoracic impedance; a factor associated with increased defibrillation success. Optimal force for the defibrillation of children < or =10 kg using paediatric paddles has previously been shown to be 2.9 kgf, and for children >10 kg using adult paddles is 5.1 kgf. We compared defibrillation paddle force applied during simulated paediatric defibrillation with these optimal values.


METHODS
72 medical and nursing staff who would be expected to perform paediatric defibrillation were recruited from a University teaching hospital. Participants, blinded to the nature of the study, were asked to simulate defibrillation of an infant manikin (9 months of age) and a child manikin (6 years of age) using paediatric or adult paddles, respectively, according to guidelines. Paddle force (kgf) was measured at the time of simulated shock and compared with known optimal values.


RESULTS
Median paddle force applied to the infant manikin was 2.8 kgf (max 9.6, min 0.6), with only 47% operators attaining optimal force. Median paddle force applied to the child manikin was 3.8 kgf (max 10.2, min 1.0), with only 24% of operators attaining optimal force.


CONCLUSIONS
Defibrillation paddle force applied during paediatric defibrillation often falls below optimal values.
Shackleton Department of Anaesthetics, Southampton University Hospital NHS Trust, Tremona Road, Southampton SO16 6YD, UK.
Sarah H
SH
Bennetts
Charles D
CD
Deakin
Graham W
GW
Petley
Frank
F
Clewlow
D001835:Body Weight; D002648:Child; D004554:Electric Countershock / Q000295:instrumentation* / Q000379:methods; D004566:Electrodes; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008348:Manikins; D008505:Medical Staff, Hospital; D009741:Nursing Staff, Hospital; D011312:Pressure; D011597:Psychomotor Performance; D016037:Single-Blind Method; D014160:Transducers, Pressure