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Quality between mechanical compression on reducible stretcher versus manual compression on standard stretcher in small elevator - 25/07/16

Doi : 10.1016/j.ajem.2016.05.072 
Tae Han Kim, MD a , Ki Jeong Hong, MD b, ⁎ , Shin Sang Do, MD, PhD c , Chu Hyun Kim, MD d , Sung Wook Song, MD e , Kyoung Jun Song, MD, PhD c , Young Sun Ro, MD, DrPH f , Ki Ok Ahn, MD, PhD f , Dayea Beatrice Jang, MPH f
a Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea 
b Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea 
c Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea 
d Department of Emergency Medicine, Inje University Seoul Pak Hospital, Seoul, Korea 
e Department of Emergency Medicine, Jeju National University Hospital, Jejudo, Korea 
f Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea 

⁎Corresponding author at: Department of Emergency Medicine, Seoul National University Boramae Medical Center, 20, Boramae-Ro 5 Gil, Dongjak-Gu, Seoul 07061, Korea. Tel.: +82 2 870 2663; fax: +82 2 831 0207.Department of Emergency MedicineSeoul National University Boramae Medical Center20, Boramae-Ro 5 GilDongjak-GuSeoul07061Korea

Abstract

Objectives

Manual cardiopulmonary resuscitation (CPR) during vertical transport in small elevators using standard stretcher for out-of-hospital cardiac arrest can raise concerns with diminishing quality. Mechanical CPR on a reducible stretcher (RS-CPR) that can be shortened in the length was tested to compare the CPR quality with manual CPR on a standard stretcher (SS-CPR).

Methods

A randomized crossover manikin simulation was designed. Three teams of emergency medical technicians were recruited to perform serial CPR simulations using two different protocols (RS-CPR and SS-CPR) according to a randomization; the first 6 minutes of manual CPR at the scene was identical for both scenarios and two different protocols during vertical transport in a small elevator followed on a basis of cross-over assignment. The LUCAS-2 Chest Compression System (Zolife AB, Lund, Sweden) was used for RS-CPR. CPR quality was measured using a resuscitation manikin (Resusci Anne QCPR, Laerdal Medical, Stavanger, Norway) in terms of no flow fraction, compression depth, and rate (median and IQR).

Results

A total of 42 simulations were analyzed. CPR quality did not differ significantly at the scene. No flow fraction (%) was significantly lower when the stretcher was moving in RS-CPR then SS-CPR (36.0 (33.8-38.7) vs 44.0 (36.8-54.4), P< .01). RS-CPR showed significantly better quality than SS-CPR; 93.2 (50.6-95.6) vs 14.8 (0-20.8) for adequate depth (P< 0.01), and 97.5 (96.6-98.2) vs 68.9(43.4-78.5) for adequate rate (P< .01).

Conclusion

Mechanical CPR on a reducible stretcher during vertical transport showed significant improvement in CPR quality in terms of no-flow fraction, compression depth, and rate compared with manual CPR on a standard stretcher.

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☆ Funding Acknowledgement: This study was supported by the “Fire Fighting Safety and 119 Rescue Technology Research and Development Program” funded by the Ministry of Public Safety and Security (Grant No.: NEMA-NextGeneration-2014-54).


© 2016  Elsevier Inc. Reservados todos los derechos.
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Vol 34 - N° 8

P. 1604-1609 - août 2016 Regresar al número
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