Does the change of educational strategy for chest compression based on the change of guidelines affect on the quality of prehospital chest compression?

Yoshihiro Moriwaki ,Kenji Ohshige ,Noriyuki Suzuki ,Mitsugi Sugiyama

doi:10.22514/sv71.042012.5

Abstract

Background and Aims. International guidelines for cardiopulmonary resuscitation (CPR) changed their strategy with res-pect to the rate of chest compression (CC) and ventilation from 15:2 to 30:2. The object of this study was to clarify the effect of this change on the quality of CPR.Subjects and Methods. We recorded the frequency of CC and ventilation performed by Emergency Life Support Technici-ans (ELSTs) during CPR in ambulances, and compared the period when ELSTs performed 15:2 CPR with that when they performed 30:2 CPR.Results. During the first period, ELSTs actually performed CCs 15 times per 7.2 sec (128.1 times per minute), and perfor-med 2 ventilations per 4.5 sec. Thirty-six percent of patients received appropriate CCs (100-120/min), while 43% received high-frequency CCs (120-150/min) and 13% received CCs that were too fast (more than 150/min). During the second period, ELSTs performed CCs 30 times per 18.1 sec (101.6 times per minute), and performed 2 ventilations per 4.3 sec. Conclusions. The change in the CC-to-ventilation ratio for CPR in the international guidelines from 15:2 to 30:2 can improve the exactness of the frequency of CCs. However, ELSTs may not be able to perform CCs exactly as recommended. It is important to evaluate the exact frequency of CCs by ELSTs or paramedics in ambulances and to evaluate the relationship between the frequency of CCs and patient outcome.

Highlights

International guidelines for cardiopulmonary resuscitation (CPR) recommend 100 chest compressions (CCs) per minute and ventilation for a minimum time
It is important to evaluate the exact frequency of CCs by Emergency Life Support Technicians (ELSTs) or paramedics in ambulances and to evaluate the relationship between the frequency of CCs and patient outcome
Study design We recorded the frequency of CCs and ventilation performed by ELSTs during CPR in ambulances, and compared between the first period, when ELSTs performed CPR according to the 2000 guidelines (15:2 CPR, n=73), and the second, when they performed CPR according to the 2005 guidelines (30:2 CPR, n=74)

Summary

Introduction

International guidelines for cardiopulmonary resuscitation (CPR) recommend 100 chest compressions (CCs) per minute and ventilation for a minimum time. In Japan, prehospital CPR is often performed by Emergency Life Support Technicians (ELSTs) belonging to the fire department. International guidelines for cardiopulmonary resuscitation (CPR) changed their strategy with respect to the rate of chest compression (CC) and ventilation from 15:2 to 30:2. ELSTs performed CCs 15 times per 7.2 sec (128.1 times per minute), and performed 2 ventilations per 4.5 sec. The change in the CC-to-ventilation ratio for CPR in the international guidelines from 15:2 to 30:2 can improve the exactness of the frequency of CCs. ELSTs may not be able to perform CCs exactly as recommended. It is important to evaluate the exact frequency of CCs by ELSTs or paramedics in ambulances and to evaluate the relationship between the frequency of CCs and patient outcome

Methods

Results

Discussion

Conclusion