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2016 ; 24
(ä): 28
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Barriers in the implementation of the Resuscitation Guidelines: European survey
of defibrillation techniques
#MMPMID26969512
Krawczyk P
; Kononowicz AA
; Andres J
Scand J Trauma Resusc Emerg Med
2016[Mar]; 24
(ä): 28
PMID26969512
show ga
BACKGROUND: The European Resuscitation Council (ERC) Guidelines recommend
providing chest compressions during defibrillator charging and using adhesive
pads for defibrillation to increase the effectiveness of resuscitation. However,
the most common defibrillation technique in each European country is unknown, as
are the potential barriers in implementation of the guidelines. The aim of this
study was to assess the techniques of defibrillation procedures performed by
professional European healthcare providers and to estimate how frequently
adhesive pads are used. METHODS: We sent an online questionnaire to the ERC
National Representatives that contained 12 questions regarding the techniques of
defibrillation and monitoring heart rhythm during cardiac arrest. We also
evaluated the frequency and indications of manual paddles use. RESULTS: We
collected questionnaires from 27 out of 33 invited ERC member countries. The
response rate was 82%. Seventeen (17/27; 63%) declared the use of adhesive pads.
The leading cause for not using adhesive pads was economic reason (9/17; 53%).
Some respondents declared resistance to using adhesive pads by healthcare
providers or tradition connected with manual paddles use. We found three leading
techniques of defibrillation with manual paddles: Charging paddles keeping them
on the defibrillator during chest compressions being delivered (9/21; 43%),
Charging paddles keeping them on the patient chest during chest compressions
being delivered (6/21; 29 %), Charging paddles on the patient chest without chest
compressions (5/21; 24%). Respondents from 11 countries declared the use of gel
or electrode pastes during defibrillation with manual paddles. DISCUSSION: This
study collected preliminary data showing how defibrillation is performed in
Europe. It revealed the recommeded techniques underuse and identyfied barriers in
the Resuscitation Guidelines implementation. The survey should be open to a wider
group of respondents. in each country in future. CONCLUSIONS: There are
limitations and barriers in the implementation of the defibrillation technique
guidelines. There are still countries where the use of adhesive pads is low due
to economic and traditional reasons. There is a need for further efforts focused
on guidelines implementation.
|*Guideline Adherence/statistics & numerical data
[MESH]