What is the optimal paddle force for defibrillation?
© BioMed Central Ltd 2001
Published: 3 July 2001
Firm paddle pressure during defibrillation is important to minimize transthoracic impedance (TTI) and optimize trans-myocardial current. Previous European Resuscitation Council (ERC) guidelines recommended that 12 kg force should be used  and the more recent International Liaison Committee on Resuscitation (ILCOR) guidelines recommend 'firm' pressure . The actual relationship between force and transthoracic impedance has not been established.
55 patients (36 male, 19 female) undergoing general anaesthesia for cardiac surgery were investigated. Male chests were shaved. A pair of gel pads and paddles were placed in the anterior-apical position according to the ILCOR guidelines. The endotracheal tube was opened to air and paddles instrumented with force sensors were applied to the chest wall with progressive force to a maximum of 12 kgf. The resultant TTI was recorded at 10 measurements per second to a hard drive.
A minimum of 6 kg force applied to each paddle is necessary to achieve 83% of the overall decrease in TTI seen at 12 kgf. Further decrease in TTI as force is applied in excess of 6 kgf is small and a force of 12 kgf only reduces TTI by a further 3.2% compared with TTI at 6 kgf. The additional clinical benefit of applying 12 kgf as opposed to 6 kgf is questionable.
- Robertson C, et al.: Resuscitation 1998, 37: 81. 10.1016/S0300-9572(98)00035-5View ArticlePubMedGoogle Scholar
- Deakin C, Petley G, Cardan E, Clewlow F: Does paddle force applied during defibrillation meet advanced life support guidelines of the European Resuscitation Council? Resuscitation 2001, 48: 301-303. 10.1016/S0300-9572(00)00265-3View ArticlePubMedGoogle Scholar