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. 2020 May 21:1-2:100004.
doi: 10.1016/j.resplu.2020.100004. eCollection 2020 Mar-Jun.

Anticipatory manual defibrillator charging during advanced life support: A scoping review

Quentin Otto  1   2 , Szymon Musiol  1 , Charles D Deakin  3 , Peter Morley  4   5 , Jasmeet Soar  2
Affiliations

Anticipatory manual defibrillator charging during advanced life support: A scoping review

Quentin Otto et al. Resusc Plus. .

Abstract

Background: Some resuscitation services advocate or teach routine manual defibrillator charging prior to a rhythm check during cardiopulmonary resuscitation.

Objectives: We aimed to review the evidence for anticipatory defibrillator charging compared with charging after a shockable rhythm is confirmed.

Methods: This scoping review was performed according to a specific methodological framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Grey literature was also reviewed using similar methodology and included in the results.

Results: There are no randomized clinical trials studying anticipatory manual defibrillator charging. The limited available data does not address critical or important patient outcomes such as defibrillation success, return of spontaneous circulation, survival to hospital discharge or neurological outcomes. Evidence primarily from manikin studies and the grey literature suggests that anticipatory charging is feasible, safe, and can reduce the total pause duration during the period of chest compression between rhythm checks, but can increase the pre-shock pause and total peri-shock pause duration.

Conclusions: Anticipatory manual defibrillator charging appears to be feasible in the clinical setting, although its impact on clinical outcomes is uncertain. Future studies of anticipatory charging should focus on clinical outcomes.

Keywords: Advanced life support; Cardiac arrest; Cardiopulmonary resuscitation; Defibrillation; Heart arrest; Manual defibrillator.

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Conflict of interest statement

QO None declared. SM None declared. CD Defibrillation domain lead, ILCOR. Trustee, RCUK. PM Chair of Australian Resuscitation Council. JS Chair of ILCOR ALS Task Force. Chair of the European Resuscitation Council ALS Science Committee. Executive committee, RCUK.

Figures

Fig. 1
Fig. 1
Defibrillation methods A: Anticipatory method – charge during chest compressions prior to rhythm check. Disarm defibrillator or dump charge if non-shockable rhythm B: Standard Method – ERC and AHA guidelines (2010 and 2015). Pause for rhythm check, chest compressions during charging. C: Old Method - pause for rhythm check, no chest compressions during charging.
Fig. 2
Fig. 2
Pauses during different defibrillation methods. A: Anticipatory method.. B: Standard method. C: Old Method a: Pre-shock pause. b: Post-shock pause c: Peri-shock pause (a+b) d: Rhythm check pause.
Fig. 3
Fig. 3
PRISMA flow diagram.
See this image and copyright information in PMC

References

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    1. International Liaison Committee on Resuscitation . 2019. ILCOR- Continuous Evidence Evaluation - Task Force Evidence Reviews Guidance Document V 1.0 SAC Approved 5 August 2019.

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