Copyright © 2008 Published by Elsevier Ireland Ltd. <h4 class="h4">AP-030 h4>
Quality of cardiopulmonary resuscitation on manikins: On the floor and in the bed
All study subjects performed CPR well within Guidelines recommendations on all four manikins with mean compression depth 44 ± 3 mm, compression rate 101 ± 3 min−1, and 7 ± 2 ventilations per minute. Three quarters stated that during CPR on patients their personal sense of correct depth and force determined their performance. Fifty-five percent believed that too deep chest compressions could cause serious injury to the patient, and 39%that compressing to Guidelines recommended depth may often result in severe patient injury. A quarter felt that the potential benefits of compressing to the Guidelines depth could not justify the injuries it would cause. Breaking ribs made 54%feel very uncomfortable.<h4 class="h4">Conclusionsh3>
Ambulance personnel were physically capable of consistently compressing to the Guidelines depth even on the stiffest chest. These laboratory results cannot be directly compared to the clinical out-of-hospital ALS situation, but strongly indicate that the inadequate chest compressions found in our clinical study were not due to lack of physical capability. We speculate that this may at least partly be explained by their fear of causing patient injury and trust in their own opinion of what is the correct compression depth and force in preference to the feedback.
ht; padding-left:5px">hide()">his.src='/scidirimg/btn_xclose_hov.gif';" onmouseout="javascript:this.src='/scidirimg/btn_xclose.gif';"> he full text of this document" title="You are entitled to access the full text of this document" width=12 height=14"> href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T19-4PC4FNW-2&_user=10&_coverDate=01%2F31%2F2008&_rdoc=1&_fmt=high&_orig=article&_cdi=4885&_sort=v&_docanchor=&view=c&_ct=5673&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=773c43ac9d85586dfe2e1c32b05eb480">Effects of rescuer position on the kinematics of cardiopulmonary resuscitation (CPR) and the force of delivered compressionsResuscitation, Volume 76, Issue 1, January 2008, Pages 69-75 Chih-Hsien Chi, Jui-Yi Tsou, Fong-Chin Su Abstract height:150%"><h3 class="h3">Summaryh3><h4 class="h4">Backgroundh3>Depending on the clinical setting, rescuers may provide CPR from a kneeling (if the patient is on the ground) or standing (if the patient is in a bed) position. The rescuer position may affect workload, and hence rate of fatigue and quality of CPR.<h4 class="h4">Purposeh3> This study evaluates how three common rescuer positions affect the kinematics of CPR and the force of delivered compressions.<h4 class="h4">Methodsh3> Subjects were 18 health care providers experienced in CPR. Each participant performed CPR from three different positions: kneeling beside the Resusci® Anne manikin placed on the floor (F); standing beside the manikin placed on a Table 63 cm in height (H), and standing beside the manikin placed on a Table 37 cm in height (L). The compression to ventilation ratio was 15:2. CPR duration was 5 min for each position, with a rest period of 50 min in-between. The order of position was randomised. The manikin was equipped with a six-axial force load cell to collect 3D compression forces at a sampling rate of 1000 Hz. An eight-camera Motion Analysis Digital System was adopted to collect 3D trajectory information. Data were compared using crossover-design analysis of variance (p < 0.05 was regarded as statistically significant). Ratings of Perceived Exertion (RPE) were measured by modified Borg scale.<h4 class="h4">Resultsh3> Significant differences were observed in the head, shoulder, lower trunk, hip and knee angles between the three methods. Lower trunk flexion angle (°) for H, L, and F were −14.52 ± 1.13, −28.83 ± 1.75, and 14.39 ± 1.14, respectively. Hip flexion angle for H, L, and F were −16.21 ± 3.30, −42.59 ± 4.75, and −47.39 ± 4.36, respectively. However, compression force (N) in H, L, and F were 455.8 ± 17.6, 455.7 ± 14.0, 461.5 ± 13.5, respectively (p > 0.05). Compression depths (mm) were: 43.5 ± 3.4, 42.0 ± 5.4, 44 ± 5.2, respectively (p > 0.05). Compression frequencies (times/min) were: 117.9 ± 12.4, 116.6 ± 13.4, 108.8 ± 11.7, respectively (p > 0.05). No differences were found between the three positions for RPE.<h4 class="h4">Conclusionsh3> In this study, while the kinematics of CPR differed significantly with varying rescuer position, these differences did not affect the compression force, depth and frequency as performed by experienced providers. href="http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6T19-4PC4FNW-2-1&_cdi=4885&_user=10&_orig=article&_coverDate=01%2F31%2F2008&_sk=999239998&view=c&wchp=dGLbVtz-zSkWz&md5=9739b5137d2c7dfbbce08938931aae67&ie=/sdarticle.pdf">http://www.sciencedirect.com/scidirimg/icon_pdf.gif" alt=""> Purchase PDF (245 K) |
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Quality of cardiopulmonary resuscitation on manikins: On the floor and in the bed