It is no exaggeration to say that knowing how to use a defibrillator correctly can save lives. New research suggests that one particular approach to pad placement is significantly more effective when it comes to getting the heart beating again.
A research team led by Oregon Health & Science University (OHSU) found that when a person in cardiac arrest has one pad placed on their chest and one pad placed on their back, they are 2.64 times more likely to restore spontaneous circulation (ROSC). It will be. Better than having pads on the front and sides.
This is based on an analysis of 255 incidents involving Portland’s Tualatin Valley Fire and Rescue Team from July 2019 to June 2023. The chest and back position (anterior-posterior or AP) was used in 158 patients, and the chest and flank position was used. In the other 97 times, body position (anterolateral or AL) was used.
“We didn’t expect to see such a big difference,” says Joshua Lupton, assistant professor of emergency medicine at OHSU. “The fact that we did so may ignite the medical community to fund further research to learn more.”
AP placement is not a new idea, and both AP and AL are used regularly by medical professionals. While AP is commonly taught to infants, the AL approach is the one most people are familiar with for adults with fibrillation, and there is little research on which options are most effective. .
Studies are being conducted to examine the differences between two approaches to treating persistent atrial fibrillation (abnormal heart rhythm): AP and AL. AP comes out on top here as well.
The idea is that the placement of the AP effectively sandwiches the heart between the two pads, allowing more electricity to reach the heart and increasing its chances of responding to the resulting electric shock.
“The key is that energy has to travel from one pad to the other through the heart,” says Mohamud Daya, professor of emergency medicine at OHSU.
There are some limitations worth noting. This is an observational study rather than one conducted under more rigorous clinical conditions, meaning that other factors may be involved in the variation in recovery rates. Additionally, AL placement is often easier to apply than AP.
Additionally, the location of the AP or AL only affects whether the heart beats again. The difference disappeared when it came to the number of people who recovered and were discharged from hospital.
This emphasizes that pad placement is only part of the picture when it comes to recovery. Still, only about 1 in 10 people survive an out-of-hospital cardiac arrest, so anything that can improve this number is worth considering.
“The shorter the time a person is in cardiac arrest, the better,” Lupton says. “The longer the brain has reduced blood flow, the less likely it will be a positive outcome.”
The study was published in JAMA Network Open.
