CPR quality during out-of-hospital cardiac arrest transport

Cheskes, Sheldon; Byers, Adam; Zhan, Cathy; Verbeek, P. Richard; Ko, Dennis T.; Drennan, Ian R.; Buick, Jason E.; Brooks, Steven C.; Lin, Steve; Taher, Ahmed; Morrison, Laurie J.

doi:10.1016/j.resuscitation.2017.02.016

Cited by 55 publications

(43 citation statements)

References 33 publications

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“…Because the highest service level of emergency medical technician (EMT) is limited to the level of intermediate EMT in the US, CPR performance may be inadequate compared to Western countries with high service level 36. In addition, feedback CPR devices that can be used to maintain the quality of CPR during transport are not widely used in Korea 37. Therefore, quality control of compression during transport is also limited in Korea.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Transport Time Interval on Neurological Recovery after Out-of-Hospital Cardiac Arrest in Patients without a Prehospital Return of Spontaneous Circulation

Park

Kim

et al. 2019

J Korean Med Sci

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Background Longer transport adversely affects outcomes in out-of-hospital cardiac arrest (OHCA) patients who do not return to spontaneous circulation (ROSC). The aim of this study was to determine the association between the transport time interval (TTI) and neurological outcomes in OHCA patients without ROSC. Methods We analyzed adult OHCA patients with presumed cardiac etiology and without prehospital ROSC from 2012 to 2015. The study population was divided into 2 groups according to STI (short STI [1–5 minutes] and long STI [≥ 6 minutes]). The primary exposure was TTI, which was categorized as short (1–5 minutes), intermediate (6–10 minutes), or long (≥ 11 minutes). The primary outcome was a good neurological recovery at discharge. Multiple logistic regression analysis was used in each STI group. Results Among 57,822 patients, 23,043 (40%), 20,985 (36%), and 13,794 (24%) were classified as short, intermediate, and long TTI group. A good neurological recovery occurred in 1.0%, 0.6%, and 0.3% of the patients in the short, intermediate and long TTI group, respectively. Among 12,652 patients with short STI, a good neurological recovery occurred in 2.2%, 1.0%, and 0.4% of the patients in the short, intermediate and long TTI group, respectively. Among 45,570 patients with long STI, a good neurological recovery occurred in 0.7%, 0.5%, and 0.3% of the patients in the short, intermediate and long TTI group, respectively. When short TTI was used as a reference, the adjusted odds ratios (AOR) of TTI for good neurological recovery was different between short STI group and long STI group (AOR [95% confidence interval, 0.46 [0.32–0.67] vs. 0.72 [0.59–0.89], respectively, for intermediate TTI and 0.31 [0.17–0.55] vs. 0.49 [0.37–0.65], respectively, for long TTI). Conclusion A longer TTI adversely affected the likelihood of a good neurological recovery in OHCA patients without prehospital ROSC. This negative effect was more prominent in short STI group.

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Section: Discussionmentioning

confidence: 99%

The Effect of Transport Time Interval on Neurological Recovery after Out-of-Hospital Cardiac Arrest in Patients without a Prehospital Return of Spontaneous Circulation

Park

Kim

et al. 2019

J Korean Med Sci

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“…The act of transferring the patient from the scene of the cardiac arrest to the ambulance and then to hospital may lead to reduction in the quality of CPR [23] . Some observational studies have reported reduced chest compression depth and more interruptions during ambulance transport compared to resuscitation at the site of the cardiac arrest [24,25,26] although this is not universally observed [27] . Un-restrained ambulance staff are at risk of musculoskeletal injuries from acceleration forces during emergency ambulance transport [8] .…”

Section: Discussionmentioning

confidence: 99%

“…154 (67.8%) patients were male, 114 (56.7%) received bystander CPR, 148 (65.2%) had comorbidities and 62 (27.3%) were living independently; however none of these characteristics were significantly different between groups ( Table 2), however when including ambulance response times, Non-uTOR terminate had longer call to scene departure and call to hospital arrival times (p<0.05 and p<0.01, respectively) than uTOR terminate. Interventions provided before hospital arrival Adrenaline was almost universally administered (n=225, 99.1%) at a median time between emergency call to first drug administration of 21 minutes (IQR [17][18][19][20][21][22][23][24][25][26][27]. Only patients in the Non-uTOR terminate group received prehospital defibrillations with a median of two shocks (IQR 1-5) at a median time from call to first defibrillation of 11 minutes (IQR 8-15).…”

Section: Patient Characteristicsmentioning

confidence: 99%

Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study

et al. 2018

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“…This idea of a strategy of support enhanced by the "bundle" of concepts is developing in the literature. Thus, Cheskes et al [24] describe a "high-quality CPR" such as the combination of a CCF greater than 70% and reaching the objectives in the recommendations for frequency and depth of CC.…”

Section: Introductionmentioning

confidence: 99%

Impacts of chest compression cycle length and real-time feedback with a CPRmeter® on chest compression quality in out-of-hospital cardiac arrest: study protocol for a multicenter randomized controlled factorial plan trial

Buléon

Parienti

Morilland-Lecoq

et al. 2020

Trials

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Background: With a survival rate of 6 to 11%, out-of-hospital cardiac arrest (OHCA) remains a healthcare challenge with room for improvement in morbidity and mortality. The guidelines emphasize the highest possible quality of cardiopulmonary resuscitation (CPR) and chest compressions (CC). It is essential to minimize CC interruptions, and therefore increase the chest compression fraction (CCF), as this is an independent factor for survival. Survival is significantly and positively correlated with the suitability of CCF targets, CC frequency, CC depth, and brief predefibrillation pause. CC guidance improves adherence to recommendations and allows closer alignment with the CC objectives. The possibility of improving CCF by lengthening the time between two CC relays and the effect of real-time feedback on the quality of the CC must be investigated.

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CPR quality during out-of-hospital cardiac arrest transport

Cited by 55 publications

References 33 publications

The Effect of Transport Time Interval on Neurological Recovery after Out-of-Hospital Cardiac Arrest in Patients without a Prehospital Return of Spontaneous Circulation

The Effect of Transport Time Interval on Neurological Recovery after Out-of-Hospital Cardiac Arrest in Patients without a Prehospital Return of Spontaneous Circulation

Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study

Impacts of chest compression cycle length and real-time feedback with a CPRmeter® on chest compression quality in out-of-hospital cardiac arrest: study protocol for a multicenter randomized controlled factorial plan trial

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