Most doctors do not position resuscitation paddles correctly

June 07, 2001

Do doctors position defibrillation paddles correctly? Observational study

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Most doctors do not position defibrillation paddles in accordance with European Resuscitation Council guidelines when attempting to resuscitate patients in cardiac arrest, finds a study in this week's BMJ.

Deakin and colleagues recruited 101 doctors of all grades and specialities at Southampton General Hospital, who were unprepared and unaware of the nature of the study. They were shown an anatomically accurate male resuscitation manikin and were asked to perform defibrillation (administering an electric shock to restore a normal heartbeat) by placing two defibrillation pads (sternal and apical) on the chest wall, on to which were placed the corresponding paddles. The position of the centre of the pads was recorded using a grid placed over the chest wall.

Overall, 65% of sternal paddles were placed within 5cm of the position recommended in the guidelines. However, only 22% of apical paddles were placed correctly. Paddle positioning did not differ between doctors' grades or specialities or between those who had received defibrillation training within the past three years and those who had not.

Given that each minute of delay in restoring normal heart rhythm increases mortality by 7-10%, teaching of advanced life support must place greater emphasis on paddle position if successful defibrillation is to be optimised, conclude the authors.

Charles Deakin, Consultant Anaesthetist, Southampton General Hospital NHS Trust, Southampton, UK

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