A Comparison of Chest Compression Quality Delivered During On-Scene and Ground Transport Cardiopulmonary Resuscitation

Russi, Christopher S.; Myers, Lucas A.; Kolb, Logan J.; Lohse, Christine M.; Hess, Erik P.; White, Roger D.

doi:10.5811/westjem.2016.6.29949

Cited by 31 publications

(17 citation statements)

References 14 publications

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“…15,16,18 The effect of interrupted high-quality CPR ambulance on patient survival outcome is uncertain; however, the possibility of a deteriorating outcome is considered. 15,18,19 Our result suggests that when EMS performed ETI before departure and decided to transfer the patient, the effect of TTI on outcomes might not be significant despite ROSC not being achieved. Our hypothesis is that chest compression can be sufficient only within a short period of arrest, but if it takes a longer time to transport the patient to an available ED, then the implementation of high-quality oxygen delivery procedure such as ETI would aid in oxygenation and ventilation in long-distance transport.…”

Section: Discussionmentioning

confidence: 77%

Association of transport time interval with neurologic outcome in out-of-hospital cardiac arrest patients without return of spontaneous circulation on scene and the interaction effect according to prehospital airway management

et al. 2022

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Objective This study analyzed the association of transport time interval (TTI) with survival rate and neurologic outcome in out-of-hospital cardiac arrest (OHCA) patients without return of spontaneous circulation (ROSC) and the interaction effect of TTI according to prehospital airway management.Methods A retrospective observational study based on the nationwide OHCA database from January 2013 to December 2017 was designed. Emergency medical service (EMS)-treated OHCA patients aged ≥18 years were included. TTI was categorized into four groups of quartiles (≤4, 5–7, 8–11, ≥12 minutes). The primary outcome was favorable neurologic outcome at discharge. The secondary outcome was survival to discharge from the hospital. Multivariable logistic regression was used to analyze outcomes according to TTI. A different effect of TTI according to the administration of prehospital EMS advanced airway was evaluated.Results In total, 83,470 patients were analyzed. Good neurologic recovery decreased as TTI increased (1.0% for TTI ≤4 minutes, 0.9% for TTI 5–7 minutes, 0.6% for TTI 8–11 minutes, and 0.5% for TTI ≥12 minutes; P for trend <0.05). The adjusted odds ratio of prolonged TTI (≥12 minutes) was 0.73 (95% confidence interval, 0.57–0.93; P<0.01) for good neurologic recovery. However, the negative effect of prolonged TTI on neurological outcome was insignificant when advanced airway or entotracheal intubation were performed by EMS providers (adjusted odds ratio, 1.17; 95% confidence interval, 0.42–3.29; P=0.76).Conclusion EMS TTI was negatively associated with the neurologic outcome of OHCA without ROSC on scene. When advanced airway was performed on scene, TTI was insignificantly associated with the outcome.

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Section: Discussionmentioning

confidence: 77%

Association of transport time interval with neurologic outcome in out-of-hospital cardiac arrest patients without return of spontaneous circulation on scene and the interaction effect according to prehospital airway management

et al. 2022

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“…Mechanical CPR offers undoubtedly a high quality of resuscitation even in special situations, including ambulance or helicopter transport. [29, 30] Mechanical CPR devices can be used for maintaining systemic perfusion during percutaneous coronary intervention, pericardiocentesis, or extracorporeal membrane oxygenation in patients with circulatory collapse or cardiac arrest. [31, 32] In this respect, further study of clinical situations where mechanical CPR is effective is needed.…”

Section: Discussionmentioning

confidence: 99%

Comparison of hemodynamic effects and resuscitation outcomes between automatic simultaneous sterno-thoracic cardiopulmonary resuscitation device and LUCAS in a swine model of cardiac arrest

Cha

Kim

et al. 2019

PLoS ONE

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Introduction Mechanical cardiopulmonary resuscitation (CPR) devices are widely used to rescue patients from cardiac arrest. This study aimed to compare hemodynamic effects and resuscitation outcomes between a motor-driven, automatic simultaneous sterno-thoracic cardiopulmonary resuscitation device and the Lund University cardiac arrest system (LUCAS). Material and methods After 2 minutes of electrically induced ventricular fibrillation (VF), Yorkshire pigs (weight 35–60 kg) received CPR with an automatic simultaneous sterno-thoracic CPR device (X-CPR group, n = 13) or the Lund University cardiac arrest system (LUCAS group, n = 12). Basic life support for 6 minutes and advanced cardiovascular life support for 12 minutes, including defibrillation and epinephrine administration, were provided. Hemodynamic parameters and resuscitation outcomes, including return of spontaneous circulation (ROSC), 24-hour survival, and cerebral performance category (CPC) at 24 hours, were evaluated. Results Hemodynamic parameters, including aortic pressures, coronary perfusion pressure, carotid blood flow, and end-tidal carbon dioxide pressure were not significantly different between the two groups. Resuscitation outcomes were also not significantly different between the groups (X-CPR vs. LUCAS; rate of ROSC: 31% vs 25%, p = 1.000; 24-hour survival rate: 31% vs 17%, p = 0.645; neurological outcome with CPC ≤2: 31% vs 17%, p = 0.645). Also no significant difference in incidence complications associated with resuscitation was found between the groups. Conclusions CPR with a motor-driven X-CPR and CPR with the LUCAS produced similar hemodynamic effects and resuscitation outcomes in a swine model of cardiac arrest.

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“…Although there is currently no randomized trial data to compare 'scoop and run' and 'stay and play' approaches to OHCA patients, we do know that intra-arrest transport interrupts and reduces CPR quality drastically [30][31][32][33]. A recent study by the Resuscitation Outcomes Consortium used a robust propensity score-matching design and found association of improved neurologically intact survival in North American OHCA patients treated on-scene compared with those who underwent intra-arrest transport [4 versus 8.5%, risk difference 4.6%, 95% confidence interval (CI) 4.0-5.1%] [34 && ].…”

Section: When To Transportmentioning

confidence: 99%

Transportation during and after cardiac arrest: who, when, how and where?

Ong

2021

Current Opinion in Critical Care

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Purpose of reviewOut-of-hospital cardiac arrest (OHCA) is the most devastating and time-critical medical emergency. Survival after OHCA requires an integrated system of care, of which transport by emergency medical services is an integral component. The transport system serves to commence and ensure uninterrupted high-quality resuscitation in suitable patients who would benefit, terminate resuscitation in those that do not, provide critical interventions, as well as convey patients to the next appropriate venue of care. We review recent evidence surrounding contemporary issues in the transport of OHCA, relating to who, where, when and how to transport these patients. Recent findingsWe examine the clinical and systems-related evidence behind issues including: contemporary approaches to field termination of resuscitation in patients in whom continued resuscitation and transport to hospital would be medically futile, OHCA patients and organ donation, on-scene versus intra-transport resuscitation, significance of response time, intra-transport interventions (mechanical chest compression, targeted temperature management, ECMO-facilitated cardiopulmonary resuscitation), OHCA in high-rise locations and cardiac arrest centers. We highlight gaps in current knowledge and areas of active research.

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A Comparison of Chest Compression Quality Delivered During On-Scene and Ground Transport Cardiopulmonary Resuscitation

Cited by 31 publications

References 14 publications

Association of transport time interval with neurologic outcome in out-of-hospital cardiac arrest patients without return of spontaneous circulation on scene and the interaction effect according to prehospital airway management

Association of transport time interval with neurologic outcome in out-of-hospital cardiac arrest patients without return of spontaneous circulation on scene and the interaction effect according to prehospital airway management

Comparison of hemodynamic effects and resuscitation outcomes between automatic simultaneous sterno-thoracic cardiopulmonary resuscitation device and LUCAS in a swine model of cardiac arrest

Transportation during and after cardiac arrest: who, when, how and where?

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