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

详细信息    查看全文

• 作者：Tae Han Kim ; MD^a ; ^{adoong2001@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Ki Jeong Hong ; MD^b ; ^{emkjhong@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Shin Sang Do ; MD ; PhD^c ; ^{shinsangdo@medimail.co.kr" class="auth_mail" title="E-mail the corresponding author} ; Chu Hyun Kim ; MD^d ; ^{juliannnn@hanmail.net" class="auth_mail" title="E-mail the corresponding author} ; Sung Wook Song ; MD^e ; ^{sungwook78@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Kyoung Jun Song ; MD ; PhD^c ; ^{skciva@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Young Sun Ro ; MD ; DrPH^f ; ^{Ro.youngsun@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Ki Ok Ahn ; MD ; PhD^f ; ^{arendt75@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Dayea Beatrice Jang ; MPH^f ; ^{dy.jang@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Emergency Medicine
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：34
• 期：8
• 页码：1604-1609
• 全文大小：694 K

文摘

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.