Chest compression depth and survival in out-of-hospital cardiac arrest

AimBystander cardiopulmonary resuscitation (CPR) is essential for improving the outcomes of sudden cardiac arrest patients. It has been reported that dispatch‐assisted CPR (DACPR) accounts for more than half of the incidence of CPR undertaken by bystanders. Its quality, however, can be suboptimal. We aimed to measure the quality of DACPR using a simulation study.MethodsWe recruited laypersons at a shopping mall and measured the quality of CPR carried out in our simulation. Dispatchers provided instruction in accordance with the standard DACPR protocol in Japan.ResultsTwenty‐three laypersons (13 with CPR training experience within the past 2 years and 10 with no training experience) participated in this study. The median chest compression rate and depth were 106/min and 33 mm, respectively. The median time interval from placing the 119 call to the start of chest compressions was 119 s. No significant difference was found between the groups with and without training experience. However, subjects with training experience more frequently placed their hands correctly on the manikin (84.6% versus 40.0%; P = 0.026). Twelve participants (52.2%, seven in trained and five in untrained group) interrupted chest compressions for 3–18 s, because dispatchers asked if the patient started breathing or moving.ConclusionThis current simulation study showed that the quality of DACPR carried out by lay rescuers can be less than optimal in terms of depth, hand placement, and minimization of pauses. Further studies are required to explore better DACPR instruction methods to help lay rescuers perform CPR with optimal quality.

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“…Vadeboncoeur et al 19. reported that optimal chest compression depth can increase the odds for survival by each 5 mm.…”

Section: Discussionmentioning

confidence: 99%

Quality of dispatch‐assisted cardiopulmonary resuscitation by lay rescuers following a standard protocol in Japan: an observational simulation study

Asai

Fukushima

Bolstad

et al. 2017

Acute Medicine & Surgery

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“…[19][20][21][22] Initial audit data showed a chest compression depth standard deviation of 13.67, such that a sample size of 40 patient participants per hospital site in each study period was required to detect a clinically important 10mm improvement in chest compression depth at 90% power and significance level of 0.05. [23] Secondary outcomes included other CPR quality metrics and patient outcomes.…”

Section: Outcome Measuresmentioning

confidence: 99%

An evaluation of three methods of in-hospital cardiac arrest educational debriefing: The cardiopulmonary resuscitation debriefing study

et al. 2016

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Copies of full items can be used for personal research or study, educational, or not-for-profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. Conflicts of interestThe authors have no conflicts of interest to declare.Word count: 2802 Acknowledgements:We gratefully acknowledge the support of Dr Richard Field, Dr Joyce Yeung and Mr Mehboob Chilwan in extracting data from defibrillator records. AbstractBackground: The use of cardiac arrest educational debriefing has been associated with

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“…[15][16][17] Clinicians must carefully adhere to CPR quality metrics: adequate compression rate, adequate compression depth, full chest recoil after each compression, minimizing pauses in compressions and avoiding excessive ventilation (Table 3). 18 It is the entire sequence of actions (flow) rather than single events that determine the success of the intervention.…”

Section: Effectiveness Of Resuscitation Effortsmentioning

confidence: 99%