Reducing the impact of intensive care unit mattress compressibility during CPR: a simulation-based study

Lin, Yiqun; Wan, Brandi; Belanger, Claudia; Hecker, Kent G.; Gilfoyle, Elaine; Davidson, Jennifer; Cheng, Adam

doi:10.1186/s41077-017-0057-y

Cited by 17 publications

(23 citation statements)

References 38 publications

(59 reference statements)

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“…Survival and neurological outcome of the patient are associated with other factors, such as time to administer epinephrine, time to defibrillate (for shockable rhythms) and underlying conditions of the victims. 29–31 In addition, CPR quality is also influenced by factors other than training, such as the type of mattress on which the patient was put, 32 the use of backboard 33 and height of the CPR providers. 34 At present, it is not practical to account for all of these confounding factors in a trial-based economic evaluation.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training

et al. 2020

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ContextAlthough distributed cardiopulmonary resuscitation (CPR) practice has been shown to improve learning outcomes, little is known about the cost-effectiveness of this training strategy. This study assesses the cost-effectiveness of workplace-based distributed CPR practice with real-time feedback when compared with conventional annual CPR training.MethodsWe measured educational resource use, costs, and outcomes of both conventional training and distributed training groups in a prospective-randomised trial conducted with paediatric acute care providers over 12 months. Costs were calculated and reported from the perspective of the health institution. Incremental costs and effectiveness of distributed CPR training relative to conventional training were presented. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio (ICER) if appropriate. One-way sensitivity analyses and probabilistic sensitivity analysis were conducted.ResultsA total of 87 of 101 enrolled participants completed the training (46/53 in intervention and 41/48 in the control). Compared with conventional training, the distributed CPR training group had a higher proportion of participants achieving CPR excellence, defined as over 90% guideline compliant for chest compression depth, rate and recoil (control: 0.146 (6/41) vs intervention 0.543 (25/46), incremental effectiveness: +0.397) with decreased costs (control: $C266.50 vs intervention $C224.88 per trainee, incremental costs: −$C41.62). The sensitivity analysis showed that when the institution does not pay for the training time, distributed CPR training results in an ICER of $C147.05 per extra excellent CPR provider.ConclusionWorkplace-based distributed CPR training with real-time feedback resulted in improved CPR quality by paediatric healthcare providers and decreased training costs, when training time is paid by the institution. If the institution does not pay for training time, implementing distributed training resulted in better CPR quality and increased costs, compared with conventional training. These findings contribute further evidence to the decision-making processes as to whether institutions/programmes should financially adopt these training programmes.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training

et al. 2020

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“…26 Physicians and other CPR providers struggle to achieve highquality CCs. 2,[7][8][9][10] Past studies have evaluated the factors that may have contributed in decreasing CC quality, such as providing CPR on a mattress. Mattresses compress during CPR.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Studies with simulated and real cardiac arrest cases have shown that, despite CPR training and its widespread use, CC providers struggle to achieve high-quality CCs and the post-CPR survival rates remain low. 2,[7][8][9][10] Many studies focused on this problem and aimed to identify the factors influencing the CC quality. The support surface is one of these factors.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 Recent studies have shown that performing CPR on mattresses reduces CC quality. 9,[12][13][14] In theory, backboard placement between the patient and the mattress should provide a firm and stable surface, should decrease the compliance of the underlying mattress by increasing the surface area of the applied force, and should decrease the distance of the vertical hand movement. These factors cause reduced workload and increased CC quality.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Backboard Placement on Chest Compression Quality: A Mannequin Study

Sanri

Karacabey

2019

Prehosp. Disaster med.

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Introduction:High-quality chest compressions (CCs) are associated with high survival rates and good neurological outcomes in cardiac arrest patients. The 2015 American Heart Association (AHA; Dallas, Texas USA) Guidelines for Resuscitation defined and recommended high-quality CCs during cardiopulmonary resuscitation (CPR). However, CPR providers struggle to achieve high-quality CCs. There is a debate about the use of backboards during CPR in literature. Some studies suggest backboards improve CC quality, whereas others suggest that backboards can cause delays. This is the first study to evaluate all three components of high-quality CCs: compression depth, recoil depth, and rate, at the same time with a high number of subjects. This study evaluated the impact of backboards on CC quality during CPR. The primary outcome was the difference in successful CC rates between two groups.Methods:This was a randomized, controlled, single-blinded study using a high-fidelity mannequin. The successful CC rates, means CC depths, recoil depths, and rates achieved by 6th-grade undergraduate medical students during two minutes of CPR were compared between two randomized groups: an experimental group (backboard present) and a control group (no backboard).Results:Fifty-one of all 101 subjects (50.5%) were female, and the mean age was 23.9 (SD = 1.01) years. The number and the proportion of successful CCs were significantly higher in the experimental group (34; 66.7%) when compared to the control group (19; 38.0%; P = .0041). The difference in mean values of CC depth, recoil depth, and CC rate was significantly higher in the experiment group.Conclusion:The results suggest that using a backboard during CPR improves the quality of CCs in accordance with the 2015 AHA Guidelines.Sanri E, Karacabey S. The impact of backboard placement on chest compression quality: a mannequin study. Prehosp Disaster Med. 2019;34(2):182–187

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“…90 , 97 , 101 , 102 , 103 , 104 , 105 CPR feedback devices that account for mattress compression (eg, the use of dual accelerometers or increasing compression depth targets) can help CPR providers ensure adequate compression depth when CPR is performed on a mattress. 95 , 99 , 101 , 103 , 105 , 106 …”

Section: Cpr Sequencementioning

confidence: 99%

Adult Basic Life Support

Berg¹,

Soar²,

Andersen³

et al. 2020

Resuscitation

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This 2020 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science With Treatment Recommendations on basic life support summarizes evidence evaluations performed for 20 topics that were prioritized by the Basic Life Support Task Force of the International Liaison Committee on Resuscitation. The evidence reviews include 16 systematic reviews, 3 scoping reviews, and 1 evidence update. Per agreement within the International Liaison Committee on Resuscitation, new or revised treatment recommendations were only made after a systematic review. Systematic reviews were performed for the following topics: dispatch diagnosis of cardiac arrest, use of a firm surface for CPR, sequence for starting CPR (compressions-airway-breaths versus airway-breaths-compressions), CPR before calling for help, duration of CPR cycles, hand position during compressions, rhythm check timing, feedback for CPR quality, alternative techniques, public access automated external defibrillator programs, analysis of rhythm during chest compressions, CPR before defibrillation, removal of foreign-body airway obstruction, resuscitation care for suspected opioid-associated emergencies, drowning, and harm from CPR to victims not in cardiac arrest. The topics that resulted in the most extensive task force discussions included CPR during transport, CPR before calling for help, resuscitation care for suspected opioid-associated emergencies, feedback for CPR quality, and analysis of rhythm during chest compressions. After discussion of the scoping reviews and the evidence update, the task force prioritized several topics for new systematic reviews.

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Reducing the impact of intensive care unit mattress compressibility during CPR: a simulation-based study

Cited by 17 publications

References 38 publications

Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training

Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training

The Impact of Backboard Placement on Chest Compression Quality: A Mannequin Study

Adult Basic Life Support

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