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Feng SY, Song YQ, Zhang YL, Li Y
Correspondence: Dr Shun Yi Feng, firstname.lastname@example.org
INTRODUCTION According to the findings of some studies, instability due to inertia during changes in speed may negatively impact the quality of chest compressions performed during cardiopulmonary resuscitation (CPR) in a moving environment. This study thus aimed to introduce a simple device that maintains the balance of a person performing CPR in a moving environment, such as an ambulance. We also sought to evaluate the effectiveness of this device in the improvement of the quality of chest compressions.
METHODS The experiment comprised a total of 40 simulated cardiopulmonary arrest scenes (20 in the experimental group and 20 in the control), in which CPR was conducted by eight paramedics. Each simulation involved two paramedics randomly selected from the eight. The ambulance took the same route from the simulated site to the hospital, and continuous CPR was performed on a manikin in the ambulance with or without the aid of our proposed novel device.
RESULTS The average number of chest compressions per simulation in the experimental and control groups was 1330.75 and 1266.60, respectively (p = 0.095). The percentage of chest compressions with adequate depth achieved in the experimental and control groups was 72% ± 4% and 50% ± 3%, respectively (p < 0.0001).
CONCLUSION By maintaining the balance of the CPR performer, our proposed novel device can offset the negative impact that instability (due to a moving environment) has on chest compressions. The device may also lead to an increase in the percentage of chest compressions that achieve adequate depth.
Keywords: ambulance, cardiopulmonary resuscitation, chest compression, instability, quality
Singapore Med J 2013; 54(11): 645-648; http://dx.doi.org/10.11622/smedj.2013226
| 1. Wik L, Steen PA, Bircher NG. Quality of bystander cardiopulmonary resuscitation influences outcome after prehospital cardiac arrest. Resuscitation 1994; 28:195-203. |
| 2. Eisenberg MS, Bergner L, Hallstrom A. Out-of-hospital cardiac arrest: improved survival with paramedic services. Lancet 1980; 1:812-5. |
| 3. Russo SG, Neumann P, Reinhardt S, et al. Impact of physical fitness and biometric data on the quality of external chest compression: a randomised, crossover trial. BMC Emerg Med 2011; 11:20. |
|4. Stone CK, Thomas SH. Can correct closed-chest compressions be performed during prehospital transport? Prehosp Disaster Med 1995; 10:121-3.|
| 5. Vadeboncoeur T, Stolz U, Panchal A, et al. Chest compression depth and survival in out-of-hospital cardiac arrest. Resuscitation 2013 Oct 12. [Epub ahead of print] |
| 6. Bellamy RF, DeGuzman LR, Pedersen DC. Coronary blood flow during cardiopulmonary resuscitation in swine. Circulation 1984; 69:174-80. |
| 7. Babbs CF, Voorhees WD, Fitzgerald KR, Holmes HR, Geddes LA. Relationship of blood pressure and flow during CPR to chest compression amplitude: evidence for an effective compression threshold. Ann Emerg Med 1983; 12:527-32. |
| 8. Kramer-Johansen J, Myklebust H, Wik L, et al. Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study. Resuscitation 2006; 71:283-92. |
| 9. Kim JA, Vogel D, Guimond G, et al. A randomized, controlled comparison of cardiopulmonary resuscitation performed on the floor and on a moving ambulance stretcher. Prehosp Emerg Care 2006; 10:68-70. |
| 10. Hwang SO, Lee KH, Cho JH, Yoon J, Choe KH. Changes of aortic dimensions as evidence of cardiac pump mechanism during cardiopulmonary resuscitation in humans. Resuscitation 2001; 50:87-93. |
| 11. Rudikoff MT, Maughan WL, Effron M, Freund P, Weisfeldt ML. Mechanisms of blood flow during cardiopulmonary resuscitation. Circulation 1980; 61:345-52. |
| 12. Travers AH, Rea TD, Bobrow BJ, et al. Part 4: CPR overview: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010; 122(18 Suppl 3):S676-84. |
| 13. Ødegaard S, Olasveengen T, Steen PA, Kramer-Johansen J. The effect of transport on quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest. Resuscitation 2009; 80:843-8. |
| 14. Herlitz J, Ekström L, Axelsson A. Continuation of CPR on admission to emergency department after out-of-hospital cardiac arrest. Occurrence, characteristics and outcome. Resuscitation 1997; 33:223-31 |
| 15. Kellermann AL, Hackman BB, Somes G. Predicting the outcome of unsuccessful prehospital advanced cardiac life support. JAMA 1993; 270:1433- 6. |