Hands Off! Stand Clear for Defib

A cadaver study identifies risks to rescuers from hands-on defibrillation.

Hands-on defibrillation minimizes pauses in cardiac compressions. But are rescuers who use this technique at risk for exposure to electric shock? To find out, investigators obtained voltage measurements while rescuers performed defibrillation on cadavers.

Rescuers were exposed to between 200 and 827 volts, depending on the cadaver and electrode location, and received between 1 and 8 joules of electrical energy, an amount that exceeds recommended exposure levels.

Comment

Exposures may have been underestimated, because the study participants used nitrile gloves, which can block electrical flow. Future protective equipment such as insulating gloves, gurneys, and railings may change protocols. However, for now, hands-on defibrillation should be considered unsafe. We should follow current guidelines that focus on high-quality chest compressions and minimizing pauses, but chest compressions and all other patient contact should cease during defibrillation.