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November 25, 1988, Vol 260, No. 20 >
ARTICLE | November 25, 1988

Spark-Generating Properties of Electrode Gels Used During Defibrillation: Title and subTitle BreakA Potential Fire Hazard FREE

Russell S. Hummel, III, BSEE; Joseph P. Ornato, MD; Stuart M. Weinberg, MD; Alex M. Clarke, PhD
[+] Author Affiliations

Reprint requests to Medical College of Virginia, Box 525, Richmond, VA 23298 (Dr Ornato).


JAMA. 1988;260(20):3021-3024. doi:10.1001/jama.1988.03410200077029
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References

After a defibrillation attempt started a fire in an oxygen-enriched intensive care unit environment, seven popular electrode gels were tested for spark-generating properties by repeated 360-J electrical discharges into a 50-Ω test load. Gels with low initial impedance (7±1 Ω) allowed a high current flow (51 ±1 A), maintained a cool temperature (27°C to 33°C), and did not spark. Gels with high initial impedance (125 ±14 Ω) allowed less current (26 ±2 A), heated to 52°C±2°C, liquified, and generated an electrical spark after the fourth or fifth discharge. Federal standards should be developed to identify and label electrode gels that can be used safely for high-current applications such as defibrillation.

(JAMA 1988;260:3021-3024)

REFERENCES

1 +
American Heart Association:  Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) . JAMA 1986;;255:2905-2989.
2 +
Gasch JA, Crampton RS, Cherwek ML, et al:  Determinants of ventricular defibrillation in adults . Circulation 1979;;60:231.
3 +
Kerber RE, Jensen SR, Gascho JA, et al:  Determinants of defibrillation: Prospective analysis of 183 patients . Am J Cardiol 1983;;52:739-745.
4 +
Kerber RE, Grayzel J, Hoyt R, et al:  Transthoracic resistance of human defibrillation: Influence of body weight, chest size, serial shocks, paddle size and paddle contact pressure . Circulation 1981;; 63:676-682.
5 +
Ewy GA, Ewy MD, Nuttall AJ, et al:  Canine transthoracic resistance . J Appl Physiol 1972;; 32:91.
6 +
Thomas ED, Ewy GA, Dahl CF, et al:  Effectiveness of direct current defibrillation: Role of paddle electrode size . Am Heart J 1977;;93:463-467.
7 +
Patel AS, Galysn FT:  Experimental studies to design safe external pediatric paddles for DC defibrillation . IEEE Trans Biomed Eng 1972;;19:228.
8 +
Connel PN, Ewy GA, Dahl CF, et al:  Transthoracic impedance to defibrillation discharge: Effect of electrode size and electrode-chest wall interface . J Electrocardiol 1973;;6:313.
9 +
Ewy GA, Horan WJ, Ewy MD:  Disposable defibrillator electrodes . Heart Lung 1977;;6:127.
10 +
Ewy GA, Taren D:  Comparison of paddle electrode pastes used for defibrillation . Heart Lung 1977;;6:847.
11 +
Geddes LA, Tacker WA, Cabler DP, et al:  Decrease in transthoracic resistance during successive ventricular defibrillation trials . Med Instrum 1975;;9:179-183.
12 +
Dahl CF, Ewy GA, Ewy MD, et al:  Transthoracic impedance to direct current discharge: Effect of repeated countershocks . Med Instrum 1976;; 10:151-155.
13 +
Ewy GA, Hellman DA, McClung S, et al:  Influence of ventilation phase on transthoracic impedance and defibrillation effectiveness . Crit Care Med 1980;;8:164-166.
14 +
Emergency Care Research Institute (ECRI):  Hazard: Defibrillation in oxygen-enriched environments . Health Devices 1987;;16:113.
15 +
Ewy GA, Taren D:  Impedance to transthoracic direct current discharge: A model for testing interface material . Med Instrum 1978;;1:47-48.
16 +
Handbook of Chemistry and Physics , ed 52. Cleveland, Chemical Rubber Co, 1971;-1972, p E 43.
17 +
Kerber RE, Grayzel J, Hoyt R, et al:  Transthoracic resistance in human defibrillation . Med Instrum 1980;;14:56.
18 +
SAS User's Guide: Statistics, Version 5 Edition . Cary, NC, SAS Institute Inc, 1985;, pp 433-506.
19 +
Parke JD, Higgins SE:  Hazards associated with chest application of nitroglycerin ointments . JAMA 1982;;248:427.
20 +
Babka JC:  Does nitroglycerin explode? N Engl J Med 1983;;309:379.
21 +
Kuhnen R, Nitsch J, Luderitz B:  Explosion of transdermal nitroglycerin during defibrillation . Dtsch Med Wochenschr 1985;;110:37.
22 +
Tacker WA, Paris R:  Transchest defibrillation effectiveness and electrical impedance using disposable conductive pads : Heart Lung 1983;;5:510-513.
23 +
 Investigation continues in NY City hospital oxygen fire . Biomed Safety Standards 1988;;18:10.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
American Heart Association:  Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC) . JAMA 1986;;255:2905-2989.
2 +
Gasch JA, Crampton RS, Cherwek ML, et al:  Determinants of ventricular defibrillation in adults . Circulation 1979;;60:231.
3 +
Kerber RE, Jensen SR, Gascho JA, et al:  Determinants of defibrillation: Prospective analysis of 183 patients . Am J Cardiol 1983;;52:739-745.
4 +
Kerber RE, Grayzel J, Hoyt R, et al:  Transthoracic resistance of human defibrillation: Influence of body weight, chest size, serial shocks, paddle size and paddle contact pressure . Circulation 1981;; 63:676-682.
5 +
Ewy GA, Ewy MD, Nuttall AJ, et al:  Canine transthoracic resistance . J Appl Physiol 1972;; 32:91.
6 +
Thomas ED, Ewy GA, Dahl CF, et al:  Effectiveness of direct current defibrillation: Role of paddle electrode size . Am Heart J 1977;;93:463-467.
7 +
Patel AS, Galysn FT:  Experimental studies to design safe external pediatric paddles for DC defibrillation . IEEE Trans Biomed Eng 1972;;19:228.
8 +
Connel PN, Ewy GA, Dahl CF, et al:  Transthoracic impedance to defibrillation discharge: Effect of electrode size and electrode-chest wall interface . J Electrocardiol 1973;;6:313.
9 +
Ewy GA, Horan WJ, Ewy MD:  Disposable defibrillator electrodes . Heart Lung 1977;;6:127.
10 +
Ewy GA, Taren D:  Comparison of paddle electrode pastes used for defibrillation . Heart Lung 1977;;6:847.
11 +
Geddes LA, Tacker WA, Cabler DP, et al:  Decrease in transthoracic resistance during successive ventricular defibrillation trials . Med Instrum 1975;;9:179-183.
12 +
Dahl CF, Ewy GA, Ewy MD, et al:  Transthoracic impedance to direct current discharge: Effect of repeated countershocks . Med Instrum 1976;; 10:151-155.
13 +
Ewy GA, Hellman DA, McClung S, et al:  Influence of ventilation phase on transthoracic impedance and defibrillation effectiveness . Crit Care Med 1980;;8:164-166.
14 +
Emergency Care Research Institute (ECRI):  Hazard: Defibrillation in oxygen-enriched environments . Health Devices 1987;;16:113.
15 +
Ewy GA, Taren D:  Impedance to transthoracic direct current discharge: A model for testing interface material . Med Instrum 1978;;1:47-48.
16 +
Handbook of Chemistry and Physics , ed 52. Cleveland, Chemical Rubber Co, 1971;-1972, p E 43.
17 +
Kerber RE, Grayzel J, Hoyt R, et al:  Transthoracic resistance in human defibrillation . Med Instrum 1980;;14:56.
18 +
SAS User's Guide: Statistics, Version 5 Edition . Cary, NC, SAS Institute Inc, 1985;, pp 433-506.
19 +
Parke JD, Higgins SE:  Hazards associated with chest application of nitroglycerin ointments . JAMA 1982;;248:427.
20 +
Babka JC:  Does nitroglycerin explode? N Engl J Med 1983;;309:379.
21 +
Kuhnen R, Nitsch J, Luderitz B:  Explosion of transdermal nitroglycerin during defibrillation . Dtsch Med Wochenschr 1985;;110:37.
22 +
Tacker WA, Paris R:  Transchest defibrillation effectiveness and electrical impedance using disposable conductive pads : Heart Lung 1983;;5:510-513.
23 +
 Investigation continues in NY City hospital oxygen fire . Biomed Safety Standards 1988;;18:10.

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