The assessment of the kinematics of the rescuer in continuous chest compression during a 10-min simulation of cardiopulmonary resuscitation

Hanna Misiołek,Andrzej Bieniek,Tomasz Stepien,Robert Michnik,Dariusz Myrcik,Jacek Karpe,Dariusz Waniczek,Arkadiusz Niczyporuk,Bogusław Bucki,Joanna Makarska

doi:10.1186/s40001-019-0369-6

Abstract

BackgroundIn pursuit of improvement in cardiopulmonary resuscitation (CPR), new technologies for the measurement and assessment of CPR quality are implemented. In our study, we assessed the kinematics of the rescuer during continuous chest compression (CCC–CPR). The proper performance of the procedure is a survival predictor for patients with cardiac arrest (CA). The purpose of the study was a prospective assessment of the kinematics of the rescuer’s body with consideration given to the depth and rate of chest compression (CC) as the indicator of properly performed CC maneuver by professional and non-professional rescuers during a simulation of a 10-min CCC using a manikin.MethodsForty participants were enrolled in the study. CCC–CPR was performed in accordance with the 2015 AHA guidelines on a manikin positioned on the floor. Kinematic data on the movement were obtained from the measuring system (X-sens MVN Biomech) transmitting information from 17 inertial sensors. Measurement data were imported to the author’s program RKO-Kinemat written in the Matlab and C # environments. Two groups of results were distinguished: Group I—results of CC with the depth of ≥ 40 mm and Group 2—CC results with the depth of < 40 mm.ResultsThe multiple regression model demonstrated that the path length, left knee flexion angle, and left elbow flexion angle were the essential elements of the rescuer’s kinematics that facilitated achieving and maintaining the normal depth of CC.ConclusionsWe believe that raising the rescuer’s hips by moving the center of the rescuer’s body over the point of sternal compression increases the value of the CC force vector, thereby increasing the depth of CC. In addition, we observed that, during an effective CC, the rescuer was unable to maintain arms straight and, in consequence, a slight elbow flexion was observed. It, however, did not influence the quality of the maneuver.

Highlights

In pursuit of improvement in cardiopulmonary resuscitation (CPR), new technologies for the measurement and assessment of CPR quality are implemented
Kinematic data on the movement of the rescuer during continuous CC CPR (CCC–CPR) were obtained from the measuring system (X-sens MVN Biomech), which transfers information from 17 inertial sensors placed on the body of the rescuer performing CCC–CPR (Fig. 2)
The examined regression model explaining the chest compression (CC) depth proved to be relevant (F = 58.200; p < 0.001) and the selected predictors totally accounted for 41.8% of the dependent variable (R2 = 0.418)

Summary

Introduction

In pursuit of improvement in cardiopulmonary resuscitation (CPR), new technologies for the measurement and assessment of CPR quality are implemented. It is suggested that, to encourage a greater number of individuals to initiate the early resuscitation, only CC should be performed [1, 2, 4,5,6,7,8,9,10,11,12] The effectiveness of this procedure is comparable to the standard CPR due to similar survival rates and a decreased number of post-resuscitation neurological deficits in persons with CA [2, 3, 5,6,7, 13,14,15,16,17,18]. The concept is reflected in a change in the sequence of the maneuver during CPR from ABC (airway, breath, and circulation) to CAB (circulation, airway, and breath) [5, 6, 16]

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