Backboard insertion in the operating table increases chest compression depth: a manikin study

Sato, Hajime; Komasawa, Nobuyasu; Ueki, Ryusuke; Yamamoto, N.; Fujii, Aya; Nishi, Shinichi; Kaminoh, Yoshiroh

doi:10.1007/s00540-011-1196-2

Cited by 28 publications

(23 citation statements)

References 11 publications

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“…A similar result was reported when CC were performed on a CPR manikin on a firm operating room bed with a pressure reduction mattress added on top. 17 Our study was different from those studies, quantifying mattress displacement during CCs coached to the deeper 2010 Guideline depth (>50 mm). This suggests that use of an externally placed sternal accelerometer device could potentially underestimate actual sternum-to-spine CC depth and potentially misguide rescuers to achieve shallower CC depth.…”

Section: Discussioncontrasting

confidence: 63%

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Backboards are important when chest compressions are provided on a soft mattress

et al. 2012

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Aim Determine the impact of backboard placement, torso weight and bed compression on chest compression (CC) depth feedback in simulated cardiac arrest patients. Methods Epochs of 50 high quality CCs with real-time feedback of sternum-to-spine compression depth were provided by a blinded BLS/ACLS/PALS certified provider on manikins of two torso weights (25 vs. 50 kg), using three bed surfaces (stretcher, Stryker hospital bed with Impression mattress, soft Total Care ICU bed), with/without a backboard (BB). Two BB sizes were tested (small: 60 cm × 50 cm; large: 89 cm × 50 cm) in vertical vs. horizontal orientation. Mattress displacement was measured using an accelerometer placed internally on the spine plate of the manikin. Mattress displacement of ≥5 mm was prospectively defined as the minimal clinically important difference. Results During CPR (CC depth: 51.8 ± 2.8 mm), BB use significantly reduced mattress displacement only for soft ICU beds. Mattress displacement was reduced (vs. no BB) for 25 kg torso weight: small BB12.3 mm (95%CI 11.9–12.6), horizontally oriented large BB 11.2 mm (95%CI 10.8–11.7), and vertically oriented large BB 12.2 mm (95%CI 11.8–12.6), and for 50 kg torso weight: small BB 7.4 mm (95%CI 7.1–7.8), horizontally oriented large BB 7.9 mm (95%CI 7.6–8.3), and vertically oriented large BB 6.2 mm (95%CI 5.8–6.5; all p < 0.001). BB size and orientation did not significantly affect mattress displacement. Lighter torso weight was associated with larger displacement in soft ICU beds without BB (difference: 6.9 mm, p < 0.001). Conclusion BB is important for CPR when performed on soft surfaces, such as ICU beds, especially when torso weight is light. BB may not be needed on stretchers, relatively firm hospital beds, or for patients with heavy torso weights.

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Section: Discussioncontrasting

confidence: 63%

“…7 However, very few studies evaluate the effectiveness of the backboard directly, and the results are inconclusive. 10–17 An important reason the prior results are inconclusive is that the quality of CC is often not optimized in these experiments. 11 …”

Section: Introductionmentioning

confidence: 99%

Backboards are important when chest compressions are provided on a soft mattress

et al. 2012

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“…Backboards are commonly used to achieve target depths [107][108][109] and reduce rescuer exertion, 110 but their placement interrupts CPR. 111 For this reason, the expert panel recommends placement of a backboard or firm, hard surface as soon as possible and in coordination with other mandatory pauses in compressions to minimize interruption time.…”

Section: Ensure a Firm Hard Surfacementioning

confidence: 99%

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Meaney¹,

Bobrow²,

Mancini³

et al. 2013

Circulation

837

521

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The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. As such, CPR quality varies widely between systems and locations. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient’s response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future.

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“…[13][14][15] To prevent the adverse effects of a hospital-bed mattress on CC, the use of a backboard, mattress compression cover and vacuum pump has been studied. 16,17 However, Nishisaki et al 18 suggested that a backboard should be used for CPR only in paediatric beds and soft beds of the intensive care unit, whereas other studies reported that the firmness of the surface had no significant effect on CPR. 5,6 In our study, there were no significant differences in CC depth between the flat floor and the three types of home-bed mattresses.…”

Section: Discussionmentioning

confidence: 99%

Effect of using a home-bed mattress on bystander chest compression during out-of-hospital cardiac arrest

Ahn

Cho

You

et al. 2019

Hong Kong Journal of Emergency Medicine

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Background: Bystander cardiopulmonary resuscitation is a key component of life-saving after an out-of-hospital cardiac arrest. In the pre-arrival instructions for out-of-hospital cardiac arrest, it is recommended that the patient be laid on a flat floor. However, the most common reason for not performing cardiopulmonary resuscitation is that the bystander could not move the patient. Objectives: This study aim to investigate the effects of using a home-bed mattress on the quality of chest compression. Methods: In this prospective, randomized study, chest compression without ventilation was performed for 4 min on a Resusci Anne manikin placed on a flat floor or on three types of home-bed mattresses (hard, medium and soft). Chest compression depth, chest compression rate and chest recoil were measured from the manikin with the Laerdal PC Skill Reporting System, and changes in chest compression quality using the four different surfaces were compared. Results: Thirty participants were enrolled to perform chest compression. There was no significant difference in chest compression depth and depth accuracy between the four surfaces. The median chest compression rates were 108.1 ± 8.5, 107.0 ± 8.3, 103.3 ± 8.9 and 98.3 ± 7.9 compressions/min (p < 0.001) for the flat floor, hard-, medium-, and soft-firmness mattresses, respectively. Moreover, there was no a significant difference in chest recoil accuracy. Conclusion: Using a home-bed mattress did not decrease the chest compression quality, except chest compression rate of soft-firmness mattress. Thus, it may be effective to initiate chest compression on a home-bed mattress if the bystander cannot move the patient to the floor.

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Backboard insertion in the operating table increases chest compression depth: a manikin study

Cited by 28 publications

References 11 publications

Backboards are important when chest compressions are provided on a soft mattress

Backboards are important when chest compressions are provided on a soft mattress

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Effect of using a home-bed mattress on bystander chest compression during out-of-hospital cardiac arrest

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