Can Correct Closed-Chest Compressions Be Performed During Prehospital Transport?

Abstract

Introduction:The resuscitation rate from out-of-hospital cardiac arrest is low. There are many factors to be considered as contributing to this phenomenon. One factor not previously considered is the impact of a moving ambulance environment on the ability to perform closed-chest compressions.Hypothesis:Proper closed-chest compressions can be performed in a moving ambulance.Methods:A cardiopulmonary resuscitation (CPR) training mannequin with an attached skill meter (Skillmeter ResusciAnnie®, Laerdal, Armonk, N. Y., USA) that measures each chest compression for proper depth and hand placement was used. Ten emergency medical technician-basic (EMT-B) certified prehospital providers were assigned into one of five teams. Each team performed a total of four sessions of five minutes of continuous closed-chest compressions on the mannequin. Two sessions were done by each team: one in the control environment with the mannequin placed on the floor, and the other in the experimental environment with the mannequin placed in the back of a moving ambulance. The ambulance was operated without warning lights and siren, and all traffic rules were obeyed. The percentage of correct closed-chest compressions was recorded for each session, and the mean values were compared using Student's t-test with alpha set at 0.01 for statistical significance.Results:Ten sessions of compressions were done in both environments. The mean percentage of correct compressions was 77.6 ±15.6 for the control group and 45.6 ±18.3 for the ambulance group (p = 0.0005).Conclusion:A moving ambulance environment appears to impair the ability to perform closed-chest compressions.

Chest Compression Energy(kg) Measurement of 4 Types of Rescue Device on the Floor

“…하지만 다양한 연구에서 일반적인 평지와 비교해 구 급차내부에서 이루어지는 심폐소생술의 질이 낮다고 보고되고 있다 7,8) . 국내에서 이루어진 연구를 살펴보면 John A 9) 은 봉고형 구급차 보다는 넓은 공간 확보가 가 능한 트럭형 구급차에서 심폐소생술의 질이 우수 했다 고 보고했으며, Choi 10) 은 평지와 비교하여 구급차 이송 중 그 질이 저하된다고 하였다.…”

On-Site Hospital Helipads: Resource Document for the NAEMSP Position Paper on On-Site Hospital Helipads

“…Tasks ranging from airway management 12,13 to advanced life support interventions 14 to chest compressions for cardiopulmonary resuscitation (CPR) 15,16 are more difficult to perform in the out-of-hospital (air or ground) transport vehicle than they are in the controlled setting of the hospital. Optimally functioning prehospital equipment may fail to detect abnormalities (e.g., cardiac dysrhythmias) easily found in the hospital environment.…”

To the Editor

“…Our study on chest compressions in an ambulance 2 did not mention that the ambulance used was a van-type ambulance, and that the speed of the vehicle was approximately 35 miles per hour with at least two turns during the compression study period. We feel that the problems with performance of chest compressions in moving ambulances are due to motion (rather than space) considerations in any but the most cramped ambulances, but we did not evaluate the ability of subjects to perform compression in an immobile vehicle.…”