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Heartstart Defibrillation Therapy Testing In Adult Victims Of Out-of-hospital Cardiac Arrest - Philips HeartStart FRx Technical Reference Manual

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LITERATURE SUMMARY
HEARTSTART FRx DEFIBRILLATOR TECHNICAL REFERENCE MANUAL
HEARTSTART DEFIBRILLATION THERAPY TESTING IN ADULT
VICTIMS OF OUT-OF-HOSPITAL CARDIAC ARREST
SUMMARY OF: Schneider T, Martens PR, Paschen H, Kuisma M,
Wolcke B, Gliner BE, Russell JK, Weaver WD, Bossaert L,
Chamberlain D. Multicenter, randomized, controlled trial of 150-J
biphasic shocks compared with 200- to 360-J monophasic shocks in
the resuscitation of out-of-hospital cardiac arrest victims. Circulation
2000 Oct 10; 102(15): 1780-7.
Introduction
The HeartStart FR2 utilizes the patented SMART Biphasic waveform. This
waveform has been extensively tested in pre-clinical and both
electrophysiology laboratory and out-of-hospital clinical studies. The
following information summarizes the results of a large study comparing the
use of SMART Biphasic AEDs to conventional monophasic in out-of-hospital
emergency resuscitation situations.
Background
Heartstream conducted an international, multicenter, prospective,
randomized clinical study to assess the effectiveness of the SMART Biphasic
waveform in out-of-hospital sudden cardiac arrests (SCAs) as compared to
monophasic waveforms. The primary objective of the study was to compare
the percent of patients with ventricular fibrillation (VF) as the initial
monitored rhythm that were defibrillated in the first series of three shocks
or fewer.
Methods
Victims of out-of-hospital SCA were prospectively enrolled in four
emergency medical service (EMS) systems. Responders used either 150 J
SMART Biphasic AEDs or 200-360 J monophasic waveform AEDs. A
sequence of up to three defibrillation shocks was delivered. For the biphasic
AEDs there was a single energy output of 150 J for all shocks. For
monophasic AEDs, the shock sequence was 200-200-360 J. Defibrillation was
defined as termination of VF for at least five seconds, without regard to
hemodynamic factors.
Results
Randomization to the use of monophasic or SMART Biphasic AEDs was done
in 338 SCAs from four emergency medical service systems. VF was observed
as the first monitored rhythm in 115 patients. The biphasic and monophasic
groups for these 115 patients were similar in terms of age, sex, weight,
primary structural heart disease, cause and location of arrest, and bystanders
witnessing the arrest or performing CPR. The average time from call to first
±
shock was 8.9
3 minutes.
F-24

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