Providing the best chest compression quality: Standard CPR versus chest compressions only in a bystander resuscitation model.

Bernhard Rössler,Karl Schebesta,Mathias Maleczek,Rainer Thell,Martina Mittlböck,Julius Goschin,Felix Piringer

doi:10.1371/journal.pone.0228702

Bernhard Rössler, Karl Schebesta + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0228702

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Abstract

Aim of the studyBystander-initiated basic life support (BLS) for the treatment of prehospital cardiac arrest increases survival but is frequently not performed due to fear and a lack of knowledge. A simple flowchart can improve motivation and the quality of performance. Furthermore, guidelines do recommend a chest compression (CC)-only algorithm for dispatcher-assisted bystander resuscitation, which may lead to increased fatigue and a loss of compression depth. Consequently, we wanted to test the hypothesis that CCs are more correctly delivered in a flowchart-assisted standard resuscitation algorithm than in a CC-only algorithm.MethodsWith the use of a manikin model, 84 laypersons were randomized to perform either flowchart-assisted standard resuscitation or CC-only resuscitation for 5min. The primary outcome was the total number of CCs.ResultsThe total number of correct CCs did not significantly differ between the CC-only group and the standard group (63 [±81] vs. 79 [±86]; p = 0.394; 95% CI of difference: 21–53). The total hand-off time was significantly lower in the CC-only group than in the standard BLS group. The relative number of correct CCs (the fraction of the total number of CCs achieving 5-6cm) and the level of exhaustion after BLS did not significantly differ between the groups.ConclusionStandard BLS did not lead to an increase in correctly delivered CCs compared to CC-only resuscitation and exhibited significantly more hand-off time. The low rate of CCs in both groups indicates the need for an increased focus on performance during BLS training.

Highlights

Sudden cardiac arrest claims 700,000 victims each year in Europe alone.[1]
The total hand-off time was significantly lower in the chest compression (CC)-only group than in the standard basic life support (BLS) group
Standard BLS did not lead to an increase in correctly delivered CCs compared to chest-compressions only (CC-only) resuscitation and exhibited significantly more hand-off time

Summary

Introduction

Sudden cardiac arrest claims 700,000 victims each year in Europe alone.[1]. Most of these sudden cardiac arrests are witnessed by lay people. Many of the victims survive because bystander-initiated cardiopulmonary resuscitation (CPR) at least doubles the survival rates of cardiac arrest.[2,3,4] lay people are fundamental as a functional chain of survival. [5,6] the rate of bystander CPR is still very low This observation is attributed to the fear of making mistakes, harming the collapsed individual, and a reluctance to perform mouth-to-mouth ventilation, among others.[7,8]. The presence of a simple flowchart indicating the necessary steps that need to be performed in BLS significantly reduces the fears of bystanders and improves the quality of BLS.[13]

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