The image of medical professionals pressing metal paddles against a patient’s chest to deliver an electric shock is common in movies and television. This portrayal often leads many to wonder if traditional paddles are still actively used in contemporary medical practice. The evolution of defibrillation technology has brought about significant changes in how these life-saving shocks are administered.
The Shift from Paddles to Pads
The medical field has moved away from traditional handheld paddles in favor of adhesive pads for defibrillation. This transition was driven by several practical advantages that enhance both patient safety and operational efficiency. Adhesive pads offer a more consistent and reliable contact with the patient’s skin, important for effective energy delivery during a shock. Unlike paddles, which require 10-12 kg of pressure and conductive gel, pads come pre-gelled and adhere directly to the skin, saving valuable time in emergency situations.
The shift to pads also improves safety for the operator. With paddles, there was a higher risk of accidental electric arc formation or contact with the patient during energy delivery. Adhesive pads allow medical staff to remain at a safer distance from the patient during the shock, as the shock button is located on the defibrillator unit itself rather than on the pads. This hands-free approach also minimizes the interruption of chest compressions during cardiopulmonary resuscitation (CPR), important for maintaining blood flow to the brain and other organs. Furthermore, pads can remain in place for continuous electrocardiogram (ECG) monitoring and even temporary transcutaneous pacing, offering more versatility than paddles.
Types of Modern Defibrillators
Modern defibrillators utilize adhesive pads, offering benefits for various medical scenarios. Automated External Defibrillators (AEDs) are the most recognizable type, designed for use by both medical professionals and laypersons in public settings. These devices are user-friendly, providing clear voice prompts and visual instructions to guide the user through the defibrillation process, including proper pad placement. AED pads adhere to the upper right chest and lower left side, ensuring the electrical current passes through the heart.
In contrast, manual external defibrillators are used by trained medical professionals in hospitals and ambulances. While some manual defibrillators can still use traditional paddles, many are now equipped with multi-function electrode pads that serve the same purpose as those on AEDs. These pads allow for continuous monitoring, defibrillation, and even pacing without requiring additional electrodes. Medical professionals using manual defibrillators must assess the patient’s heart rhythm, determine the appropriate energy level, and decide when to deliver the shock. The flexibility of adhesive pads allows for different placement configurations, such as anterior-posterior (front and back), which can improve the chances of successful defibrillation.