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SEMIAUTOMATED EXTERNAL DEFIBRILLATORS FOR IN-HOSPITAL EARLY DEFIBRILLATION: A COMPARATIVE STUDY

Published online by Cambridge University Press:  10 February 2014

Federico Nocchi ,
Pietro Derrico ,
Gerardina Masucci ,
Carlo Capussotto ,
Corrado Cecchetti  and
Matteo Ritrovato
Federico Nocchi
Affiliation:
Clinical Technology Innovation Research Area and Clinical Engineering Department, Bambino Gesù Children's Hospital, IRCCS
Pietro Derrico
Affiliation:
Clinical Technology Innovation Research Area and Clinical Engineering Department, Bambino Gesù Children's Hospital, IRCCS
Gerardina Masucci
Affiliation:
Clinical Engineering Department, Bambino Gesù Children's Hospital, IRCCS; Ingegneria Biomedica Santa Lucia S.p.A.
Carlo Capussotto
Affiliation:
Clinical Engineering Department, Bambino Gesù Children's Hospital, IRCCS
Corrado Cecchetti
Affiliation:
Emergency Department, Bambino Gesù Children's Hospital, IRCCS
Matteo Ritrovato
Affiliation:
Clinical Technology Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS
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Abstract

Objectives: Semiautomated external defibrillators (AEDs) should be considered as a means to facilitate in-hospital early defibrillation (IHED) in areas where advanced life support rescuers are not readily available. In this study, we aimed to develop a checklist and a measurement protocol to evaluate and compare AEDs by assessing factors that may affect IHED.

Methods: A clinical and technical comparison of six AEDs was performed. Technical specifications were analyzed, while an emergency team evaluated ergonomics and appropriateness for IHED at Bambino Gesù Children's Hospital. A measurement protocol was implemented, which aimed to assess the ability of defibrillators to recognize shockable and nonshockable rhythms, accuracy of delivered energy, and charging time.

Results: Designs of AEDs differed in several features which influence their appropriateness for IHED. Some units showed poor ergonomics and instructions/feedback for cardiopulmonary resuscitation. Differences between defibrillators in recognizing shockable and nonshockable rhythms emerged for polymorphic ventricular tachycardia waveforms and when the frequency and amplitude of input signals varied. Tests for accuracy revealed poor performances at low and high impedance levels for most AEDs. Notably, differences greater than 20 seconds were found in the time from power-on to “ready for discharge.”

Conclusions: The approach we used to assess AEDs allowed us to evaluate their appropriateness with respect to the organizational context, to measure their parameters, and to compare models. Results showed that ergonomics and/or performances (timing and accuracy) could be improved in each device.

Keywords

DefibrillatorsTechnology assessmentBiomedicalBiomedical engineeringCardiopulmonary resuscitationDeathSuddenCardiac
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 30 , Issue 1 , January 2014 , pp. 78 - 89
Copyright
Copyright © Cambridge University Press 2014 

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