Influenece of the CPRmeter on angular position of elbows and generated forces during cardiopulmonary resuscitation

Abstract

Objectives: It is commonly known that ergonomics in emergency medical services (EMS) is very important. Emergency medical services workers are exposed to different conditions and they should perform a variety of tasks. Material and Methods: The aim of the work has been to analyze the angular position of elbows and forces generated by the upper limbs during cardiopulmonary resuscitation with and without the CPRmeter based on feedback technology. Ten male paramedics and 10 male non-paramedics, in a kneeling position, performed cardiopulmonary resuscitation (CPR) on an Ambu Megacode manikin placed on the ground. Measurements were taken after 1 min and 4 min following the beginning of the trial. The angular position of the elbows was evaluated with a BTS Smart DX 7000 motion capture system. Kistler platforms 9286BA were used for measuring forces. Results: In the paramedic group, one statistically significant difference was observed in the mean difference between maximal and minimal right elbow angle in the 1st min without the device vs. the mean difference in the 4th min without the device. In the paramedic group, a 25% force decrease was observed after 4 min of resuscitation in trials without the CPRmeter in comparison to the 1st min. In trials with the CPRmeter, the force parameters were similar in the 1st and 4th min and more stable. No statistically significant differences were noticed in the control group. Conclusions: The CPRmeter has influence on the magnitude of the forces applied by the upper limbs and on the optimization of the rescuer effort during cardiopulmonary resuscitation. The CPRmeter had no influence on the position of the upper part of the kinematic chain. Int J Occup Med Environ Health 2017;30(6):909-916

Application of Technology in Cardiopulmonary Resuscitation, a Narrative Review

“…A CPRmeter is a device which gives real-time feedback related to the depth and rate of chest wall movement during compression and detects whether the patient's chest is able to fully recoil between compressions. Some studies evaluating the CPRmeter showed stability of force applied after 4 min of CPR or greater and optimization of positioning with improvement in compression depth and rate, however, additional studies suggest that compression quality was inferior to standard CPR and there were delays in initiation of CPR [17,22,23]. One study looked at the accuracy of placement of a "CPR Assist" feedback device by medical personnel and found that approximately half of the time the device was in an inappropriate position on the chest, increasing the risk of sternal and rib fractures [24].…”