- Design
- Single-centre retrospective video-review cohort
- Population
- 223 adults with non-traumatic OHCA arriving without ROSC
- Primary outcome
- Time to first ED rhythm analysis
- Effect
- 143 s sooner (116–169) with EMS equipment; first shock 131.5 s sooner (8–272)
A single-centre, video-review study in Annals of Emergency Medicine (published 11 June) examined 223 adults brought in with non-traumatic out-of-hospital cardiac arrest without prior return of circulation. In 75 the first emergency department rhythm analysis used the ambulance crew's monitor and pads; in 148 the team switched to department equipment first.
Using the ambulance equipment was associated with a first rhythm analysis 143 seconds sooner (95% CI 116–169) and first defibrillation about 132 seconds sooner (95% CI 8–272). Moving the patient to the ED bed took 15 seconds longer. Survival numbers were too small to compare: 44 reached admission and 8 discharge.
The groups differed — shockable rhythms were more common in the ambulance-equipment group — and this is observational. But two minutes without rhythm analysis in a shockable arrest is a long time, and swapping pads at the door is a habit rather than a necessity.
- Agree locally that the first ED rhythm check uses the ambulance defibrillator already attached
- Swap to department equipment during a planned pause, not on arrival
- Keep compressions going through the transfer to the bed
- Audit time from arrival to first rhythm analysis in your department
Why it matters
It removes a routine delay to defibrillation that costs nothing to fix.
Don't overread it
This is observational, single-centre data and did not show a survival difference.
The statistics, in plain English
The 143-second difference has a tight interval, so the delay from switching is consistent. The defibrillation interval (8 to 272 seconds) is wide because few patients were shocked. Survival could not be compared with only 8 survivors.
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