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Potentieel schadelijke interacties tussen automatische externe defibrillatoren en hulpverleners

Paul Calle (UGent) and Koenraad Monsieurs (UGent)
(2009) TIJDSCHRIFT VOOR GENEESKUNDE. 65(14-15). p.677-682
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Abstract
Potentially faulty interactions between automated external defibrillators and professional health care providers Many studies have demonstrated that automated external defibrillators (AEDs) save lives. The accuracy of the ECG analysis algorithm (i.e. "shock" versus "no shock" decisions) and the willingness of the users to follow the voice prompts (especially "stand clear" and "start cardiopulmonary resuscitation") are keys for the success of AED programs. A shortcoming of AEDs is the reduced sensitivity and specificity of the ECG analysis algorithm in the presence of external artifacts. This prospective, observational study of 135 prehospital resuscitation attempts intended to investigate if care providers (i.e. basic and advanced life support [BLS and ALS] providers) follow the voice prompts of the AED, and the consequences if they do not execute them. In the presence of ALS providers, 286 ECG rhythm analyses were performed. In the 96 analyses with shockable rhythms, artefacts were detected in 35 (36%), leading to a wrongful no shock decision in 19 (20%). Corresponding data for BLS providers included 67 analyses with artefacts in 18 (27%) but a wrong no shock decision in only 3 (4%). In the 190 analyses of a non shockable rhythm in the presence of ALS providers, artefacts were detected in 120 (63%) leading to one spurious shock (0.5%). Corresponding data for BLS providers included 157 analyses, with artefacts in 87 (55%) but no spurious shocks. We conclude that external artefacts were frequently found, sometimes leading to important errors. Consequently, more training is needed, especially for ALS providers.

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Chicago
Calle, Paul, and Koenraad Monsieurs. 2009. “Potentieel Schadelijke Interacties Tussen Automatische Externe Defibrillatoren En Hulpverleners.” Tijdschrift Voor Geneeskunde 65 (14-15): 677–682.
APA
Calle, Paul, & Monsieurs, K. (2009). Potentieel schadelijke interacties tussen automatische externe defibrillatoren en hulpverleners. TIJDSCHRIFT VOOR GENEESKUNDE, 65(14-15), 677–682.
Vancouver
1.
Calle P, Monsieurs K. Potentieel schadelijke interacties tussen automatische externe defibrillatoren en hulpverleners. TIJDSCHRIFT VOOR GENEESKUNDE. 2009;65(14-15):677–82.
MLA
Calle, Paul, and Koenraad Monsieurs. “Potentieel Schadelijke Interacties Tussen Automatische Externe Defibrillatoren En Hulpverleners.” TIJDSCHRIFT VOOR GENEESKUNDE 65.14-15 (2009): 677–682. Print.
@article{1182751,
  abstract     = {Potentially faulty interactions between automated external defibrillators and professional health care providers
Many studies have demonstrated that automated external defibrillators (AEDs) save lives. The accuracy of the ECG analysis algorithm (i.e. {\textacutedbl}shock{\textacutedbl} versus {\textacutedbl}no shock{\textacutedbl} decisions) and the willingness of the users to follow the voice prompts (especially {\textacutedbl}stand clear{\textacutedbl} and {\textacutedbl}start cardiopulmonary resuscitation{\textacutedbl}) are keys for the success of AED programs. A shortcoming of AEDs is the reduced sensitivity and specificity of the ECG analysis algorithm in the presence of external artifacts.
This prospective, observational study of 135 prehospital resuscitation attempts intended to investigate if care providers (i.e. basic and advanced life support [BLS and ALS] providers) follow the voice prompts of the AED, and the consequences if they do not execute them.
In the presence of ALS providers, 286 ECG rhythm analyses were performed. In the 96 analyses with shockable rhythms, artefacts were detected in 35 (36\%), leading to a wrongful no shock decision in 19 (20\%). Corresponding data for BLS providers included 67 analyses with artefacts in 18 (27\%) but a wrong no shock decision in only 3 (4\%).
In the 190 analyses of a non shockable rhythm in the presence of ALS providers, artefacts were detected in 120 (63\%) leading to one spurious shock (0.5\%). Corresponding data for BLS providers included 157 analyses, with artefacts in 87 (55\%) but no spurious shocks.
We conclude that external artefacts were frequently found, sometimes leading to important errors. Consequently, more training is needed, especially for ALS providers.},
  author       = {Calle, Paul and Monsieurs, Koenraad},
  issn         = {0371-683X},
  journal      = {TIJDSCHRIFT VOOR GENEESKUNDE},
  language     = {dut},
  number       = {14-15},
  pages        = {677--682},
  title        = {Potentieel schadelijke interacties tussen automatische externe defibrillatoren en hulpverleners},
  volume       = {65},
  year         = {2009},
}