Sheffield Teaching Hospitals Trust has been named for two years running as the top performing trust in the UK Good Hospital Guide. And for good reason. Sheffield follows the current research carefully and translates it into practice. Most recently this practice drove the choice of the defibrillator for the trust.
When Chan et al1 reported that the window of time for early defibrillation was more likely two minutes, not three as originally thought, it was clear that Sheffield first responders had to be comfortable using the defibrillator. Time was of the essence for a code team to deliver a timely shock to improve outcomes from sudden cardiac arrest. Coupled with the evidence that high quality CPR is critical for good outcomes, Sheffield’s resuscitation officers began to explore various options.
The goal was to find a solution that could be readily adopted by the basic life support (BLS) trained first responders, yet would ensure a smooth transition to Advanced Cardiac Life Support (ACLS) teams. Sheffield considered using a “lay person” AED in the wards, but this would necessitate changing out the cables and defibrillator pads to be compatible with the manual defibrillator when it arrived. Conversely, experience showed that inexperienced BLS-trained providers were not comfortable using manual defibrillators, even ones that had a clearly marked AED button. The new ZOLL R Series® Plus defibrillator met the goal perfectly.
When it is turned on, only a single AED button is displayed and the debrillator immediately begins analysis or prompts the rescuer to start CPR. With its full CPR feedback capability for correct rate and depth of chest compressions, this simple device encourages the first responder to take action. When the ACLS team arrives, the entire manual defibrillator face illuminates by pressing a key, allowing the team to take over without pause. Its See-Thru CPR® filter helps minimize pauses in compressions, allowing operators to visualize the underlying organized rhythm without stopping CPR.
As Sheffield begins to deploy its newest equipment, staff will be tracking outcomes to see how well this new technology improves such key measures as time to first shock, CPR quality and, most importantly, the increase in the number of patients who ultimately survive long enough to leave the hospital.1Chan, P.S. et al. 2008. Delayed Time to Defibrillation after In-Hospital Cardiac Arrest. NEJM. 358(1): 9-17.