#AAEM15 Winters: 18% Inc in mortality per 5 seconds of pause during CPR. http://t.co/QpVVdvYx7F
— San Antonio EM (@SanAntonioEM) March 2, 2015
"In patients with cardiac arrest presenting in a shockable rhythm during the ROC PRIMED trial, shorter pre- and peri-shock pauses were significantly associated with higher odds of survival. Future cardiopulmonary education and technology should focus on minimizing all peri-shock pauses." (Cheskes et all., 2013)
Decreasing peri-shock pauses is a good thing.
|Fig. 2. Cheskes et all., 2013|
However, as technology evolves and research continues we may find a way to safely keep hands on during the entire incident. With the increasing frequency of CPR quality monitoring devices (or CPR pucks as I've called them so far) we may have a viable barrier to protect providers from electrical shocks, with the risk of redirecting high voltage electricity into monitors worth thousands of dollars.
Until that day, remember an 80% CCF and rate of 100-120. feel free to use this excellent reference material for a rate.
Cheskes, S., Schmicker, R. H., Verbeek, P. R., Salcido, D. D., Brown, S. P., Brooks, S., … Christenson, J. (2014). The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial. Resuscitation, 85(3), 336–42. doi:10.1016/j.resuscitation.2013.10.014
Meaney, P. A., Bobrow, B. J., Mancini, M. E., Christenson, J., de Caen, A. R., Bhanji, F., … Leary, M. (2013). Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation, 128(4), 417–35. doi:10.1161/CIR.0b013e31829d8654
Neumann, T., Gruenewald, M., Lauenstein, C., Drews, T., Iden, T., & Meybohm, P. (2012). Hands-on defibrillation has the potential to improve the quality of cardiopulmonary resuscitation and is safe for rescuers-a preclinical study. Journal of the American Heart Association, 1(5), e001313. doi:10.1161/JAHA.112.001313