Analysis of the quality of chest compressions during resuscitation in an understaffed team — randomised crossover manikin study

Abstract

INTRODUCTION: According to the chain of survival, chest compressions (CCs) are crucial in every cardiac arrest patient. It is very challenging to provide high-quality resuscitation in a two-paramedic team. The task of an automatic chest compression device (ACCD) is to relieve the rescuer and improve the quality of CCs. Its influence on the quality of the whole resuscitation as well as the survival of patients is still subject to discussion worldwide. This study aimed to assess the quality of CCs during resuscitation in a two-paramedic team using ACCD. MATERIAL AND METHODS: This research was designed as a prospective, randomised, cross-over, high-fidelity simulation study. Fifty-two double paramedic teams took part in the research. The role of the participants was to conduct full advanced resuscitation in a human patient’s simulator. Each team provided resuscitation twice. Once with an ACCD and once using manual compressions. Chest compression quality parameters, as well as chest compression fraction (CCF), were measured. RESULTS : Statistically significant differences were found between manual and automated compressions in: mean depth (48 ± 4 mm vs. 56 ± 3 mm, p < 0.0001), mean rate (117 ± 9 mm vs. 103 ± 1 mm, p < 0.0001), percentage of CC with correct depth (46 ± 25 vs. 87 ± 13, p < 0.0001), rate (72 ± 22 vs. 96 ± 4, p < 0.0001), and recoil (55 ± 23 vs. 89 ± 13, p < 0.0001). CCF was also higher when the ACCD was used (74 ± 7% vs. 83 ± 2%, p < 0.0001). CONCLUSIONS: The use of an ACCD increases the quality of compressions by improving CCF, chest recoil, and the percentage of compressions performed with adherence to guidelines.