Comparative Evaluation of Chest Compression in a 30degrees Inclined Lateral Position Designed for Pregnant Cardiac Arrest Patients-Manikin Study

ABSTRACT

PURPOSE: Appropriate aortocaval compression during cardiopulmonary resuscitation (CPR) plays a significant role in outcomes following cardiac arrest during pregnancy. The existing aortocaval compression women may have due to pregnancy conditions can be relieved by either manual displacement of the gravid uterus or by placing the patient in an inclined lateral position. Hence, the objective of this study was to compare the quality of chest compression in two different positions, supine versus 30degrees inclined lateral, to ascertain whether or not high quality CPR is feasible in an inclined position for treating cardiac arrest during pregnancy. METHODS: A prospective, crossover, randomized study was performed with thirty emergency medicine residents and emergency medical technicians. Each participant performed hands-only CPR for 2 minutes in both supine and 30degrees inclined lateral positions on a manikin. Compression rate, depth, compression depth rate, recoil rate, and hand positioning were evaluated using the Laerdal PC SkillReporting System(R). Participants were scored on the subjective difficulty of chest compression using a visual analogue scale (VAS). RESULTS: There were no significant differences in compression rates, correct recoil rates and correct hand position ratings between the two positions. The compression depth in the supine position was 56.1+/-4.5 mm, and 52.6+/-6.5 mm (p<0.001) in the 30degrees inclined lateral position. However, the latter result met the current guideline recommendation. There was no reported difference in the difficulty of chest compression between the two positions. CONCLUSION: In the 30degrees inclined lateral position, high-quality chest compression is feasible to achieve in simulated cardiac arrest associated with pregnancy.