| English term or phrase: Paddles | 请问在以下的上下文中如何翻译Paddles，谢谢！！！
Self-Adhesive Defibrillation Pads Compared With PaddlesALS-E-037A
In adult cardiac arrest (out-of-hospital [OHCA], in-hospital [IHCA]) does the use of self-adhesive defibrillation pads, compared with paddles, improve outcomes (eg, successful defibrillation, ROSC, survival)?
Consensus on Science
Since 2005 there have been no new studies comparing self-adhesive defibrillation pads with paddles in cardiac arrest. Evidence from one small, good-quality controlled study (LOE 3)7 in 1987 showed that self-adhesive pads were associated with a significantly improved rate of ROSC and hospital admission compared with hand-held paddles. Several studies have shown the practical benefits of pads over paddles for routine monitoring and defibrillation.8–12
One prospective study (LOE 3)13 found lower TTI when paddles applied at an optimal force of 8 kg were compared with pads. In a cohort study in patients with atrial fibrillation (LOE 2)14 the use of hand-held paddles placed in the anterior-posterior position increased the success rate of monophasic cardioversion compared with similarly placed self-adhesive electrodes for monophasic defibrillation. The overall cardioversion success rate for biphasic defibrillators was high (>95%) in all groups. In the majority of other studies, self-adhesive electrodes were associated with similarly high cardioversion success rates.
Treatment Recommendation
For both defibrillation and AF cardioversion, when using biphasic defibrillators, self-adhesive defibrillation pads are safe and effective and are an acceptable alternative to standard defibrillation paddles. In AF cardioversion using monophasic defibrillators, hand-held paddles are preferable.
Placement of Paddles/PadsALS-E-030A
In adult cardiac arrest (OHCA, IHCA) does the use of any specific paddle/pad size/orientation and position, compared with standard resuscitation (or other specific paddle/pad size/orientation and position), improve outcomes (eg, successful defibrillation, ROSC, survival)?
Consensus on Science
There are no studies in patients with VF/pulseless VT directly comparing the effects of various positions of paddle/pad placement on defibrillation success and ROSC. Most studies evaluate cardioversion (eg, AF) or secondary end points (eg, TTI). Eleven studies (LOE 5)15–25 found all 4 positions (anterior-apex, anterior-posterior, anterior–left infrascapular, anterior–right infrascapular) to be equally effective in defibrillation (for VF/pulseless VT) or elective AF cardioversion success. Four studies support the anterior-posterior position (LOE 5),26–30 1 study supports the anterior-lateral position (LOE 5),31 and 1 study supports the anterior-apex position (LOE 5).32
Five studies (LOE 5)16,21–24 found no effect of electrode position on TTI. One study showed that paddles/pads should be placed under the breast tissue (LOE 5)33 and 2 studies showed that hirsute males should be shaved before the application of pads (LOE 5).34,35 Of the 36 studies reviewed, only 4 examined biphasic waveforms (LOE 5)18,25,29,36 that have gained widespread use.
Treatment Recommendation
It is reasonable to place paddles/pads on the exposed chest in an anterior-lateral position. Acceptable alternative positions are anterior-posterior (for paddles/pads) and apex-posterior (for pads). In large-breasted individuals it is reasonable to place the left electrode paddle/pad lateral to or underneath the left breast, avoiding breast tissue. Consideration should be given to the rapid removal of excessive chest hair before the application of paddles/pads but emphasis must be on minimizing delay in shock delivery.
Size of Paddles/PadsALS-E-030A
In adult cardiac arrest (OHCA, IHCA) does the use of any specific paddle/pad size/orientation and position, compared with standard resuscitation (or other specific paddle/pad size/orientation and position), improve outcomes (eg, successful defibrillation, ROSC, survival)?
Consensus on Science
No new clinical study on this topic has been published since 2005. One study demonstrated that TTI decreased and shock success increased with increasing pad size (from 8 to 12 cm) (LOE 3).37 Ten other studies showed that larger paddle/pad sizes (8- to 12-cm diameter) lowered TTI and that maximum paddle/pad size was limited by the chest wall size and anatomy (LOE 3;38 LOE 523,36,39–45). No data related to survival outcome was included in these studies.
Treatment Recommendation
There is insufficient evidence to recommend a specific electrode size for optimal external defibrillation in adults. However, it is reasonable to use a paddle/pad size >8 cm. |
| Jianming SunKudoZ activityQuestions: 2132 (none open) ( 13 closed without grading) Answers: 1174
| | Local time: 13:38
|
|
peer agreement (net): +3