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Best Evidence Topic reports
Manual pressure augmentation to enhance defibrillation in cardiac arrest
  1. Emma Carley1,
  2. Simon Carley2
  1. 1University of Nottingham School of Medical and Surgical Sciences, Nottingham, England, UK
  2. 2Emergency Medicine, Manchester NHS Foundation Trust, Manchester, UK
  1. Correspondence to Professor Simon Carley; Simon.Carley{at}mft.nhs.uk

Abstract

A shortcut review of the literature was conducted to determine whether manual pressure augmentation improves the outcome from cardiac arrest. A total of nine publications were screened by title and abstract and one study (a case report and literature review) underwent full-text review. A further review of bibliographies of relevant papers found one further relevant study protocol. Details about the author, date of publication, country of publication, patient group studied, study type, relevant outcomes (survival and return of spontaneous circulation rate), results and study limitations were tabulated. The clinical bottom line is that, in adult patients in ventricular fibrillation or ventricular tachycardia, manual pressure augmentation during defibrillation may reduce impedance. This might improve defibrillation success, but there is insufficient evidence to recommend this without further research.

  • Out-of-Hospital Cardiac Arrest
  • Defibrillators
  • Cardiopulmonary Resuscitation

https://doi.org/10.1136/emermed-2025-215019

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    Footnotes

    • Handling editor Richard Body

    • X @EMManchester

    • Contributors SC conceived the original idea. ELJC and SC jointly developed the BET and conducted separate searches. ELJC drafted the BET. SC advised, reviewed and edited the final draft. SC is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Disclaimer Best Evidence Topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practising clinicians. The search strategies used to find the best evidence are reported in detail in order to allow clinicians to update searches whenever necessary. Each BET is based on a clinical scenario and ends with a clinical bottom line which indicates, in the light of the evidence found, what the reporting clinician would do if faced with the same scenario again. This BET was first published on the BestBETs website at http://www.bestbets.org and has been reproduced with permission.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.