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Am J Emerg Med. 2016 Aug;34(8):1604-9. doi: 10.1016/j.ajem.2016.05.072. Epub 2016 May 29.

Quality between mechanical compression on reducible stretcher versus manual compression on standard stretcher in small elevator.

Author information

1
Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea. Electronic address: adoong2001@gmail.com.
2
Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea. Electronic address: emkjhong@gmail.com.
3
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. Electronic address: shinsangdo@medimail.co.kr.
4
Department of Emergency Medicine, Inje University Seoul Pak Hospital, Seoul, Korea. Electronic address: juliannnn@hanmail.net.
5
Department of Emergency Medicine, Jeju National University Hospital, Jejudo, Korea. Electronic address: sungwook78@gmail.com.
6
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. Electronic address: skciva@gmail.com.
7
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea. Electronic address: Ro.youngsun@gmail.com.
8
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea. Electronic address: arendt75@gmail.com.
9
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea. Electronic address: dy.jang@gmail.com.

Abstract

OBJECTIVES:

Manual cardiopulmonary resuscitation (CPR) during vertical transport in small elevators using standard stretcher for out-of-hospital cardiac arrest can raise concerns with diminishing quality. Mechanical CPR on a reducible stretcher (RS-CPR) that can be shortened in the length was tested to compare the CPR quality with manual CPR on a standard stretcher (SS-CPR).

METHODS:

A randomized crossover manikin simulation was designed. Three teams of emergency medical technicians were recruited to perform serial CPR simulations using two different protocols (RS-CPR and SS-CPR) according to a randomization; the first 6 minutes of manual CPR at the scene was identical for both scenarios and two different protocols during vertical transport in a small elevator followed on a basis of cross-over assignment. The LUCAS-2 Chest Compression System (Zolife AB, Lund, Sweden) was used for RS-CPR. CPR quality was measured using a resuscitation manikin (Resusci Anne QCPR, Laerdal Medical, Stavanger, Norway) in terms of no flow fraction, compression depth, and rate (median and IQR).

RESULTS:

A total of 42 simulations were analyzed. CPR quality did not differ significantly at the scene. No flow fraction (%) was significantly lower when the stretcher was moving in RS-CPR then SS-CPR (36.0 (33.8-38.7) vs 44.0 (36.8-54.4), P< .01). RS-CPR showed significantly better quality than SS-CPR; 93.2 (50.6-95.6) vs 14.8 (0-20.8) for adequate depth (P< 0.01), and 97.5 (96.6-98.2) vs 68.9(43.4-78.5) for adequate rate (P< .01).

CONCLUSION:

Mechanical CPR on a reducible stretcher during vertical transport showed significant improvement in CPR quality in terms of no-flow fraction, compression depth, and rate compared with manual CPR on a standard stretcher.

PMID:
27318749
DOI:
10.1016/j.ajem.2016.05.072
[Indexed for MEDLINE]

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