Risk assessment of electric shock to the general public without Personal Protective Equipment during defibrillation shock delivery: A simulation study

Resusc Plus. 2024 Jul 31:19:100734. doi: 10.1016/j.resplu.2024.100734. eCollection 2024 Sep.

Abstract

Aim: This study aimed to elucidate the risk of electric shock when the general public, not wearing Personal Protective Equipment (PPE), is in contact with a patient, and a defibrillation shock is inadvertently delivered.

Methods: A simulation study was conducted simulating the following scenarios. 1) Both the rescuer and the patient were isolated from the ground, with the rescuer making single-point contact with the patient. 2) Both the rescuer and the patient were in contact with the common ground, and the rescuer made single-point contact with the patient. 3) The rescuer made contact at two different points to the patient. A mannequin with a towel saturated with 3% saline solution placed on the chest was used. Defibrillation shocks were delivered using a defibrillator three times at each of three energies: 150 J, 200 J, and 360 J. The voltage across the simulated rescuer was measured with an oscilloscope.

Results: In Scenario 1, all measurements were below the detection limit. In Scenario 2, the voltage and current across the rescuer increased with higher defibrillation shock energy, averaging 156.8 V and 156.8 mA at 360 J. In Scenario 3, voltage peaked at 326.0 V and current at 326.0 mA at 360 J.

Conclusion: In a simulated setting of defibrillation, over 300 mA of current could pass through the rescuer without PPE when having two contact points between the manikin and the rescuer. However, due to the brief duration and low energy, immediate danger to the rescuer is considered low.

Keywords: Automated External Defibrillator; Basic Life Support; Cardiopulmonary Resuscitation; Electric Countershock; Out-of-Hospital Cardiac Arrest.