Is a mechanical-assist device better than manual chest compression? A randomized controlled trial

Abstract

BackgroundChest compression quality is a determinant of survival from sudden cardiac arrest. The CPR RsQ Assist Device (CPR RAD) is a new cardiopulmonary resuscitation device for chest compression. It is operated manually but it does not pull up on the chest on the up stroke. The aim of this study was to compare the CPR RAD with standard manual compression in terms of chest compression quality in a manikin model.MethodsParticipants were randomly assigned to either the device or manual chest compression group. Each participant performed a maximum of 4 minutes of hands-only compression with or without the device. During chest compression, the following quality parameters from the manikin were recorded: compression rate, compression depth, and correctness of hand position.ResultsDuration of chest compression was significantly higher in device users compared with manual compression (223.93±36.53 vs 179.67±50.81 seconds; P<0.001). The mean compression depth did not differ in a statistically significant way between manual compression and device at 2 minutes (56.42±6.42 vs 54.25±5.32; P=0.052). During the first and second minutes, compression rate was higher in cases of standard compression (133.21±15.95 vs 108±9.45; P<0.001 and 127.41±27.77 vs 108.5±9.93; P<0.001). There was no statistically significant difference in the percentage of participants who employed compression that was too shallow or exhibited incorrect hand position.ConclusionThe CPR RAD is more effective in chest compression compared with manual chest compression, as using the device led to better results in terms of fatigue reduction and correct compression rate than standard manual compression.

Manual cardiopulmonary resuscitation versus mechanical cardiopulmonary resuscitation: Which one is more effective during ambulance transport?

“…According to a study by Yuksen et al ., there was no difference between the depth of the CPR compressions obtained in a stable setting by MCCD and that obtained by a health-care professional. [ 10 ] Similar to our study, Fox et al . found that paramedics performed the appropriate chest compression depth by 67%.…”

Manual CPR Vs Mechanical CPR: Which One Is More Effective During Ambulance Transport?

“…According to a study by Yuksen et al, there was no difference between the depth of the CPR compressions obtained in a stable setting by MCCD and that obtained by a healthcare professional. 10 Similar to our study, Fox et al found that paramedics performed the appropriate chest compression depth by 67%. 11 In two different studies, the compression application difference between EMS professionals and two different automated-CPR devices was evaluated, and the compression depth provided by automated-CPR devices was found to be more appropriate than those of paramedics.…”

Real-time audio-visual feedback with handheld nonautomated external defibrillator devices during cardiopulmonary resuscitation for in-hospital cardiac arrest: A meta-analysis

“…[ 3 , 30 31 32 33 34 35 , 74 ] Real-time AVF is one strategy identified by the AHA and ILCOR as a strategy that may improve guideline adherence and IHCA outcomes. [ 27 33 35 ] Simulated studies show improved CPR quality with feedback devices [Tables 2 and 3 ];[ 42 44 45 ], 48 ,, 52 ,[ 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 ] however, the evidence for improvement in clinical outcomes is still very limited [Tables 4 and 5 ]. [ 3 51 73 74 ] That said, these devices have also been shown to be easy to use by both medical professionals and lay persons[ 45 ] and remain an understudied opportunity to improve IHCA outcomes.…”

“…Stand-alone AVF devices provide benefits in cost and simplicity, making them potentially useful for applications both in-and outside of hospital settings. Despite an abundance of non-randomized and simulation studies [Tables 2 and 3 42 44 45 48 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 ] data from clinical randomized controlled trials (RCT) are sparse [ Table 4 ]. [ 3 51 73 74 ] To date, there have been no < 15 non-AED compression AVF devices have been released to market [ Table 1 ].…”