Jel,
If you put ten resuscitation experts in a room and ask them this question,
you will get 15 different answers! The solution is to lock the door of that
room!!
Some ALS Instructors (myself included) teach monitoring through leads rather
than 'quick look paddles' for the simple reason that the rhythm on the
screen is more reliable. With the best will in the world, the paddles view
can still be distorted by artefact (incorrect pressure, movement etc). If
leads can be quickly applied with the top two leads applied over bony
prominences, there is a greater chance that you will get a more reliable
trace. Obviously, if the leads cannot be attached swiftly, the paddles view
is acceptable (provided the operator understands the limitations). The
cynics might say that the worst thing you can do with paddles view is
incorrectly diagnose a cardiac arrest rhythm as VF and shock. This is
probably quite a valid opinion as well.
I personally have not heard about the 'lag time' theory (sounds like guff to
me!). As far as I am aware, there is nothing published on this subject
(certainly, nothing in 'Resuscitation' over the last 3 years that I have
found, which is one of the journals most likely to have something like
this). I'm willing to be corrected on this however.
Andy Lockey
RC(UK)
-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]]On Behalf Of Jel Coward
Sent: 30 October 1999 19:21
To: [log in to unmask]
Subject: Defibrillation
Hi all
Has anyone heard of a recommendation that we shouldn't be monitoring
through paddles in when managing cardiac arrests?
I was teaching on an ALS refresher last week and there was no mention of
it.
I have only heard this today. Apparently it is to do with lag time for
paddles to monitor - and thus they may continue to show a previous
rhythm or appear to show asystole. I am told that something has been
published on this but am pitifully unaware of it
Any clues?
Cheers
--
Jel Coward
..take a look at the Wilderness Emergency Medicine and Command Physician
courses
http://www.wildmedic.org
[log in to unmask]
'There's no such thing as bad weather - just bad clothing"
Anon Norwegian
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