title: Decreasing the time to defibrillation: a comparative study of defibrillator electrode designs.
abstract: BACKGROUND
  Time to defibrillation (T(defib)) is the most important modifiable factor affecting survival from cardiac arrest. Mortality increases by approximately 7--10% for each minute of defibrillation delay. The purpose of this study was to determine whether defibrillator electrode design complexity affects T(defib).
  
  
  METHODS
  This was a randomized sequential design study utilizing a standardized ventricular fibrillation cardiac arrest model for CPR mannequins. We evaluated two common types of defibrillator electrode models: a single connector design and a double connector design that requires an adaptor. We compared the time required by cardiac arrest team leaders to apply the two types of defibrillator electrodes to a manikin, connect them to a defibrillator, and then deliver a first defibrillatory shock. The primary outcome was time to defibrillation. The secondary outcome was difficulty of application as perceived by the physician participants on a 10 cm visual analog scale.
  
  
  RESULTS
  Thirty-two residents performed a sequential assessment of both electrodes. The average T(defib) for the double connector model was 42.9s longer than that of the single connector model (87.5s versus 44.6s, p<0.001). As evaluated by the study participants, the single connector model was significantly easier to apply then the double connector model (1.3 cm versus 4.4 cm, p<0.001).
  
  
  CONCLUSIONS
  The single connector defibrillator electrode design was associated with a significantly shorter T(defib) than the double connector design. It also was judged to be easier to apply in this model. Ergonomic design of defibrillator electrodes can significantly impact time to defibrillation.
authors.affiliation: Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA. bruce.adams@amedd.army.mil
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Adams
authors.forename: David M
authors.initials: DM
authors.lastname: Easty
authors.forename: Elaine
authors.initials: E
authors.lastname: Stuffel
authors.forename: Irma
authors.initials: I
authors.lastname: Hartman
mesh_terms: D047548:Defibrillators; D004554:Electric Countershock / Q000295:instrumentation*; D004566:Electrodes; D004867:Equipment Design; D004869:Equipment Safety; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008348:Manikins; D008953:Models, Anatomic; D011336:Probability; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000628:therapy*