ABSTRACT
@#Background: Maintaining good quality CPR while transporting out-of-hospital cardiac arrest patients is very challenging. We aim to determine how different ambulance speed can affect the quality of chest compression performed either manually or mechanically. Methods: This was an observational manikin-based study. A total of 96 participants as well as two types of mechanical compression devices: Lucas-2 and AutoPulse, performed one minute of continuous chest compression on BT-CPEA programmed manikin while the ambulance travelled at different speeds, i.e., idle state, 30km/hr and 60km/hr. Seven outcome variables of chest compression were measured. Performance data of different groups of compressor were compared and analysed using repeated measures analysis of variance (ANOVA). Results: In manual chest compression, significant variation were noted among different speeds in term of average compression rate (p<0.001), average compression depth (p=0.007), fraction of adequate/insufficient compression depth and fraction of normal hands positioning with p=0.018, 0.022 and 0.034 respectively. Overall, AutoPulse and Lucas-2 were not affected by ambulance speed. Lucas2 showed more consistent average compression rate, higher fraction of adequate compression depth and reduced fraction of insufficient compression depth as compared to manual compression with p<0.001, 0.001 and 0.043 respectively. Conclusion: In this study we found that ambulance speed significantly affected certain aspects of manual chest compression most notably compression depth, rate and hand positioning. AutoPulse and Lucas-2 can improve these aspects by providing more consistent compression rate, depth and fraction of adequate compression depth during transport.
ABSTRACT
Continuous chest compressions during the transportation of patients with cardiac arrest have always been a difficult part in the field of pre-hospital emergency cardiopulmonary resuscitation (CPR). How to ensure continuous high-quality chest compressions is an important part of the patient's entire rescue process. At present, mechanical compression devices are commonly used to provide continuous high-quality chest compressions during the transportation. However, the installation process of the mechanical compression device involves posture changes of the patient, the placement of the device base, etc., and it is very likely to affect the continuous high-quality CPR treatment in the pre-hospital emergency process with limited human resources. Therefore, the First Affiliated Hospital of Huzhou University and Huzhou University jointly designed a rescue stretcher dedicated for CPR mechanical compression device, and has obtained the national utility model patent (ZL 2019 2 1005444.9). The main design feature of this stretcher is that the base of the compression device is combined with the stretcher, which eliminates the installation and fixation process of the base during the installation of the mechanical compression device, shortens the installation time. It has certain clinical applications value.