Metrics of mechanical chest compression device use in out‐of‐hospital cardiac arrest

Research output: Contribution to journalArticle

Abstract

Objective
The quality of cardiopulmonary resuscitation (CPR) affects outcomes from cardiac arrest, yet manual CPR is difficult to administer. Although mechanical CPR (mCPR) devices offer high quality CPR, only limited data describe their deployment, their interaction with standard manual CPR (sCPR), and the consequent effects on chest compression continuity and patient outcomes. We sought to describe the interaction between sCPR and mCPR and the impact of the sCPR‐mCPR transition upon outcomes in adult out‐of‐hospital cardiac arrest (OHCA).
Methods
We analyzed all adult ventricular fibrillation OHCA treated by the Anchorage Fire Department (AFD) during calendar year 2016. AFD protocols include the immediate initiation of sCPR upon rescuer arrival and transition to mCPR, guided by patient status. We compared CPR timing, performance, and outcomes between those receiving sCPR only and those receiving sCPR transitioning to mCPR (sCPR + mCPR).
Results
All 19 sCPR‐only patients achieved return of spontaneous circulation (ROSC) after a median of 3.3 (interquartile range 2.2–5.1) minutes. Among 30 patients remaining pulseless after sCPR (median 6.9 [5.3–11.0] minutes), transition to mCPR occurred with a median chest compression interruption of 7 (5–13) seconds. Twenty‐one of 30 sCPR + mCPR patients achieved ROSC after a median of 11.2 (5.7–23.8) additional minutes of mCPR. Survival differed between groups: sCPR only 14/19 (74%) versus sCPR + mCPR 13/30 (43%), P = 0.045.
Conclusion
In this series, transition to mCPR occurred in patients unresponsive to initial sCPR with only brief interruptions in chest compressions. Assessment of mCPR must consider the interactions with sCPR.

Details

Authors
Organisations
External organisations
  • University of Alaska Anchorage
  • University of Arizona
  • Physio-Control/Jolife AB
  • Resurgent Biomedical Consulting
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
Original languageEnglish
Pages (from-to)1214-1221
JournalJournal of the American college of emergency physicians open
Volume1
Issue number6
Early online date2020 Jul 4
Publication statusPublished - 2020
Publication categoryResearch
Peer-reviewedYes

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