Spotlight on Research

Electrical cardioversion has been the recommended treatment for the management of the peri-arrest patient with a clinically unstable tachyarrhythmia for some time now. Despite this, its use in UK paramedic practice is uncommon and synchronised cardioversion tends to be an in-hospital intervention or a physician-led out-of-hospital intervention. South East Coast Ambulance Service National Health Service (NHS) Foundation Trust (SECAmb) has developed a workforce of specialist paramedics in critical care who have been able to deliver synchronised cardioversion for certain tachycardias as part of their increased skillset. The patient groups suitable for this intervention align with the Resuscitation Council guidelines.

This retrospective cross-sectional descriptive study looked at all available cases from the SECAmb electronic Critical Care Patient Database where synchronised cardioversion had been used. The data were interrogated to provide demographic, physiological, and efficacy data, and a sub-group was created to identify those who presented with a primary arrhythmia (as opposed to post cardiac arrest). Those with primary arrhythmia were of primary interest as they avoided the many confounding factors that are associated with the post-cardiac arrest physiology and the mixed aetiologies.