title: The effect of compressor-administered defibrillation on peri-shock pauses in a simulated cardiac arrest scenario.
abstract: BACKGROUND
  Coordination of the tasks of performing chest compressions and defibrillation can lead to communication challenges that may prolong time spent off the chest. The purpose of this study was to determine whether defibrillation provided by the provider performing chest compressions led to a decrease in peri-shock pauses as compared to defibrillation administered by a second provider, in a simulated cardiac arrest scenario.
  
  
  METHODS
  This was a randomized, controlled study measuring pauses in chest compressions for defibrillation in a simulated cardiac arrest model. We approached hospital providers with current CPR certification for participation between July, 2011 and October, 2011. Volunteers were randomized to control (facilitator-administered defibrillation) or experimental (compressor-administered defibrillation) groups. All participants completed one minute of chest compressions on a mannequin in a shockable rhythm prior to administration of defibrillation. We measured and compared pauses for defibrillation in both groups.
  
  
  RESULTS
  Out of 200 total participants, we analyzed data from 197 defibrillations. Compressor-initiated defibrillation resulted in a significantly lower pre-shock hands-off time (0.57 s; 95% CI: 0.47-0.67) compared to facilitator-initiated defibrillation (1.49 s; 95% CI: 1.35-1.64). Furthermore, compressor-initiated defibrillation resulted in a significantly lower peri-shock hands-off time (2.77 s; 95% CI: 2.58-2.95) compared to facilitator-initiated defibrillation (4.25 s; 95% CI: 4.08-4.43).
  
  
  CONCLUSIONS
  Assigning the responsibility for shock delivery to the provider performing compressions encourages continuous compressions throughout the charging period and decreases total time spent off the chest. However, as this was a simulation-based study, clinical implementation is necessary to further evaluate these potential benefits.
authors.affiliation: Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Joshua
authors.initials: J
authors.lastname: Glick
authors.affiliation: Penn State Hershey College of Medicine, Department of Public Health Sciences, Hershey, Pennsylvania.
authors.forename: Erik
authors.initials: E
authors.lastname: Lehman
authors.affiliation: The Ohio State University, College of Medicine, Department of Emergency Medicine, Columbus, Ohio.
authors.forename: Thomas
authors.initials: T
authors.lastname: Terndrup
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D008297:Male; D008348:Manikins