DO PULSE CHECKS CAUSE A SIGNIFICANT DELAY IN THE INITIAL DEFIBRILLATION SEQUENCE

This study was undertaken to determine if checking for a purse between initial defibrillations causes a clinically significant delay in the administration of the defibrillations. Ten emergency department nurses and 10 emergency medicine resident physicians were timed delivering t hree successive defibrillations (200, 300 and 360 J) to a manikin unde r three randomly assigned scenarios: (1) without pulse checks; (2) wit h pulse checks performed by an assistant; and (3) with pulse checks pe rformed by the participant. All participants performed the three defib rillation scenarios using three different models of defibrillators, Re peated measures analysis of variance was used to compare mean defibril lation times for the three scenarios. The mean lime was 20.4 +/- 1.0 s defibrillation without pulse checks; 20.2 +/- 1.2 s with pulse checks by an assistant and 22.0 +/- 2.0 s with pulse checks by the participa nt. There was a statistically significant difference between no pulse checks and pulse checks by the participant. No statistically significa nt difference was noted between no pulse checks and pulse checks by an assistant. We conclude that checking for a pulse does cause a statist ically significant delay in the administration of defibrillations. Thi s difference, however, is not likely to be clinically relevant. (C) 19 97 Elsevier Science Ireland Ltd.