Abstract
BackgroundMechanical chest compression (mCPR) offers advantages during transport under cardiopulmonary resuscitation. Little is known how devices of different design perform en-route. Aim of the study was to measure performance of mCPR devices of different construction-design during ground-based pre-hospital transport.MethodsWe tested animax mono (AM), autopulse (AP), corpuls cpr (CC) and LUCAS2 (L2). The route had 6 stages (transport on soft stretcher or gurney involving a stairwell, trips with turntable ladder, rescue basket and ambulance including loading/unloading). Stationary mCPR with the respective device served as control. A four-person team carried an intubated and bag-ventilated mannequin under mCPR to assess device-stability (displacement, pressure point correctness), compliance with 2015 ERC guideline criteria for high-quality chest compressions (frequency, proportion of recommended pressure depth and compression-ventilation ratio) and user satisfaction (by standardized questionnaire).ResultsAll devices performed comparable to stationary use. Displacement rates ranged from 83% (AM) to 11% (L2). Two incorrect pressure points occurred over 15,962 compressions (0.013%). Guideline-compliant pressure depth was > 90% in all devices. Electrically powered devices showed constant frequencies while muscle-powered AM showed more variability (median 100/min, interquartile range 9). Although physical effort of AM use was comparable (median 4.0 vs. 4.5 on visual scale up to 10), participants preferred electrical devices.ConclusionAll devices showed good to very good performance although device-stability, guideline compliance and user satisfaction varied by design. Our results underline the importance to check stability and connection to patient under transport.
Highlights
Mechanical chest compression offers advantages during transport under cardiopulmonary resuscitation
In order to draw up specifications for the requirements of Mechanical chest compression (mCPR) equipment for centralized procurement in the German Free State of Bavaria, we carried out the study presented here
Device-stability under transport conditions Correct pressure point An incorrect pressure point was recorded for 2 of 15,962 compressions (0.013%). Both were measured at the beginning of the application of corpuls cpr during soft stretcher transport
Summary
Mechanical chest compression (mCPR) offers advantages during transport under cardiopulmonary resuscitation. Aim of the study was to measure performance of mCPR devices of different construction-design during ground-based pre-hospital transport. There are situations in which mCPR appears to offer advantages and the guidelines of the European Resuscitation Council (ERC) consider mCPR devices as a “reasonable alternative” [5,6,7]. This is especially true in situations when ROSC is unlikely to occur as a result of a “stay-and-play”-approach and when more sophisticated interventions will be required e.g. catheter intervention in myocardial infarction with refractory ventricular fibrillation or prolonged efforts are necessary to eliminate the root causes of cardiac arrest e.g. in severe hypothermia or when antagonizing tricyclic antidepressant intoxication. To our best of knowledge, there is no study so far, that has compared mCPR devices of different design their performance within all relevant settings during ground-based prehospital transport. In order to draw up specifications for the requirements of mCPR equipment for centralized procurement in the German Free State of Bavaria, we carried out the study presented here
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