Abstract 296: Quality Analysis of Cardiopulmonary Resuscitation From Two Emergency Medical Service Systems Using a Feedback Device

Abstract

Background: High quality cardiopulmonary resuscitation (CPR) plays a critical role in the success of out-of-hospital resuscitation from sudden cardiac arrest (SCA). AHA guidelines provide protocol to achieve recommended targets for CPR quality metrics including chest compression fraction (CCF), percentage of chest compressions (CCs) with full chest recoil, CC rate and CC depth. Our objective was to report the CPR quality of two emergency medical services (EMS) agencies with different basic life support (BLS) CPR protocols. Methods: Data from 673 patients, 2015 to 2017, suffering out-of-hospital SCA were obtained from Philips FR3 AEDs. The Philips Q-CPR tool was used for real-time CPR feedback, and CC waveforms were recorded for retrospective CPR analysis using Philips Event Review Pro 5.0 and custom software. The two EMS systems had BLS protocol differences: Site 1(King County, WA, n = 93) applied a compression - ventilation ratio of 30:2, while Site 2 (Mecklenburg County, NC, n = 580) applied 200 compressions in each CPR interval and ventilations were performed during CCs. Analyses were performed comparing CPR metrics between sites and to AHA targets. Results: There were 3,460 minutes of resuscitation data analyzed, representing the initial phase of resuscitation prior to ALS. The proportion of cases with shocks was 21.5% (20 of 93) for site 1 and 16.9% (98 of 580) for site 2 (p = 0.3). Both sites achieved guideline metrics though there were statistical differences (Table 1). Compared to site 1, site 2 was associated with a higher CCF, faster CC rate, but less CC depth on average (p < 0.001). Conclusions: High quality CPR defined by AHA guidelines was achieved with both sites during the early phase of AED resuscitation though some differences were observed. Additional investigation should identify equipment, or rescuer characteristics that are important to consistently achieve high quality CPR and how the combination might be tailored to optimize individual patient outcome.