The effect of transport on quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest

Odegaard, Silje; Olasveengen, Theresa M.; Steen, Petter Andreas; Kramer‐Johansen, Jo

doi:10.1016/j.resuscitation.2009.03.032

Cited by 63 publications

(36 citation statements)

References 32 publications

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“…In the control group, the number of compressions per simulation was 1266.60, but the percentage of chest compressions that achieved adequate depth was only 50% (Table II). This low percentage confirms present speculations that the quality of chest compressions is relatively substandard during transport, (13) and that the survival rates of patients with cardiac arrest who are given CPR while transported to a hospital remain poor. (14,15) In the experimental group, the number of This experiment simulated real-life CPR.…”

Section: Discussionsupporting

confidence: 83%

Evaluation of a novel device that maintains the balance of a cardiopulmonary resuscitation performer in a moving ambulance to improve chest compression quality

Feng

Song²,

Zhang³

et al. 2013

smedj

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is inevitable, this instability decreases the quality of chest compressions during transport. As such, the environment in a moving ambulance results in a lower percentage of chest compressions that achieve adequate depth, compared to chest compressions performed on an unmoving ground.In this study, we introduce the use of a novel device, that was designed to minimise the adverse effects of changes in speed in a moving vehicle on the quality of chest compressions. We conducted a randomised experiment to evaluate the effectiveness of this device in improving the quality of chest compressions. M E TH O DSA randomised experiment was conducted to assess the effectiveness of the use of a novel device in improving the depth of chest compressions performed during CPR in a moving environment. Individuals who were not implementers in the experiment were assigned the tasks of grouping, design, data collection and analysis. The randomisation method, including sequence generation, allocation concealment and implementation, is detailed in the Appendix. We used the same route, timing, paramedics and ambulance driver for both the preliminary experiment and actual experiment.Each simulation required two randomly selected paramedics (out of a total of eight paramedics) to perform CPR. In the experimental group, paramedics performed CPR with the aid of our proposed device, whereas in the control group, the paramedics performed CPR without the aid of the proposed device. A sample size of 40 ambulance trips was required to

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Section: Discussionsupporting

confidence: 83%

Evaluation of a novel device that maintains the balance of a cardiopulmonary resuscitation performer in a moving ambulance to improve chest compression quality

Feng

Song²,

Zhang³

et al. 2013

smedj

View full text Add to dashboard Cite

show abstract

“…2 Despite the evidence of survival benefit with optimal CPR delivery, CPR quality in both in-hospital and out-of-hospital remains poor. [3][4][5] Many studies have documented poor retention of CPR skills after standard courses. [6][7][8][9][10] Based on the results of their systematic review, Mancini et al suggest that CPR skill decay occurs as rapidly as 3 months.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of instructor assessment of chest compression quality during simulated resuscitation

Brennan

McGraw

Brooks

2016

CJEM

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Objectives: The 2010 American Heart Association Guidelines stress the importance of high quality cardiopulmonary resuscitation (CPR) as a predictor of survival from cardiac arrest. However, resuscitation training is often facilitated and evaluated by instructors without access to objective measures of CPR quality. This study aims to determine whether instructors experienced in the area of adult resuscitation (emergency department staff and senior residents) can accurately assess the quality of chest compressions as a component of their global assessment of a simulated resuscitation scenario. Methods: This is a prospective observational study in which objective chest compression quality data (rate, depth, and fraction) were collected from the simulation manikin and compared to subjective instructor assessment. Data were collected during weekly simulation training sessions for residents, medical students, and nursing students. Results: We included data from 24 simulated resuscitation scenarios assessed by 1 of 15 instructors. Subjective assessment of chest compression quality identified an adequate compression rate (100-120 compressions per minute) with a sensitivity of 0.17 (confidence interval [CI] 0.02-0.32) and specificity of 0.06 (CI −0.04-0.15), adequate depth (>50 mm) with a sensitivity of 0 and specificity of 0.38 (CI 0.18-0.57), and adequate fraction (>80%) with a sensitivity of 1 and a specificity of 0.25 (CI 0.08-0.42). Conclusion: Instructor assessment of chest compression rate, depth, and fraction demonstrates poor sensitivity and specificity when compared to the data from the simulation manikin. These results support the use of objective and technologically supported measures of chest compression quality for feedback during resuscitation education using simulators. RÉSUMÉObjectif: Dans les lignes directrices de 2010 de l'American Heart Association, on insiste sur l'importance de la qualité de la réanimation cardiopulmonaire (RCP) comme facteur prévisionnel de survie à un arrêt cardiaque. Toutefois, les séances de formation de réanimation sont souvent données et évaluées par des instructeurs, sans mesure objective de la qualité de la RCP. L'étude visait à déterminer si les instructeurs expérimentés dans le domaine de la réanimation chez les adultes (personnel au service des urgences, résidents séniors) pouvaient évaluer avec exactitude la qualité des compressions thoraciques, et ce, comme l'un des éléments de l'évaluation globale de scénarios de réanimation. Méthode: Il s'agit d'une étude d'observation prospective, dans laquelle il y a eu collecte de données objectives sur la qualité des compressions thoraciques (fréquence, profondeur, fraction) à partir de simulations sur mannequin, et comparaison avec l'évaluation subjective des instructeurs. Les données ont été recueillies durant les séances hebdomadaires de simulation, préparées à l'intention des résidents, des étudiants en médecine et des étudiants en soins infirmiers. Résultats: Les données recueillies provenaient de 24 séances de simula...

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“…Two recent large multi-centre RCTs with the LUCAS- [91 && ] and AutoPulse [92 && ] mechanical chest compression device, have both shown similar survival compared with manual CPR. Obviously, mechanical CPR is the preferred CPR method during transport [93,94]. There are no data to support the use of any of the available mechanical chest compression devices over another.…”

Section: Ultrasound Imagingmentioning

confidence: 99%

Towards cardiopulmonary resuscitation without vasoactive drugs

Sunde

Olasveengen

2014

Current Opinion in Critical Care

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There is currently no evidence to support any specific drugs during cardiac arrest. Good-quality CPR, early defibrillation and goal-directed postresuscitation care is more important. Healthcare systems should not prioritize implementation of unproven drugs before good quality of care can be documented. More drug studies are indeed required, and future research needs to incorporate better diagnostic tools to test more specific and tailored therapies that account for underlying causes and individual responsiveness.

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The effect of transport on quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest

Cited by 63 publications

References 32 publications

Evaluation of a novel device that maintains the balance of a cardiopulmonary resuscitation performer in a moving ambulance to improve chest compression quality

Evaluation of a novel device that maintains the balance of a cardiopulmonary resuscitation performer in a moving ambulance to improve chest compression quality

Accuracy of instructor assessment of chest compression quality during simulated resuscitation

Towards cardiopulmonary resuscitation without vasoactive drugs

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