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Zhang N, Wang J, Li Y, Liu J, Zhu H. How Does Rescuer's Position Setting Impact Quality of Chest Compression: A Randomized Crossover Simulation Study on Unexperienced Clinicians. Emerg Med Int 2024; 2024:9950885. [PMID: 39148894 PMCID: PMC11325014 DOI: 10.1155/2024/9950885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 04/16/2024] [Accepted: 06/13/2024] [Indexed: 08/17/2024] Open
Abstract
Background High-quality chest compression (CC) is the crux of survival for cardiac arrest patients. While, rescuers' position setting relative to patients during CC was unrecommended in the present guidelines. We aimed to assess the impact of position settings on CC quality during cardiopulmonary resuscitation (CPR) and to test the heterogeneity related to rescuers' characteristics. Methods We conducted randomized, crossover, simulation trials with clinical students unfamiliar with CPR. The participants received standard training on performing CC and were divided randomly into two groups. The two groups separately performed CC with standing and kneeling positions in turn, forming the crossover design. The trials were performed with standard manikin models. CC quality indicator data were recorded by the tracking and feedback system automatically. Result 156 participants finished at least one round of trial, with 126 participants finishing both rounds. Records for CC with kneeling and standing positions showed statistically significant differences in the correct rate, pause happening, average depth, and happening of over-depth compression. Regression analysis also implied that larger compression depths with the standing position were related to larger height and BMI of the participants. Conclusion When performing CC, the standing position will lead to lower CC quality by larger chance of pause happening and over-depth compression. In addition, compression depth gaps between CC with kneeling and standing position were related with rescuer characteristics including height and BMI, with a threshold effect.
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Affiliation(s)
- Nan Zhang
- Emergency Department The State Key Laboratory for Complex Severe and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jiangshan Wang
- Emergency Department The State Key Laboratory for Complex Severe and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yan Li
- Emergency Department The State Key Laboratory for Complex Severe and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jihai Liu
- Emergency Department The State Key Laboratory for Complex Severe and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Huadong Zhu
- Emergency Department The State Key Laboratory for Complex Severe and Rare Diseases Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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Charungwatthana N, Laohakul P, Tangsuwanaruk T, Wittayachamnankul B. Effectiveness of innovative chest compression on the emergency department stretcher by an alternative method: a randomized controlled crossover trial. Sci Rep 2024; 14:12284. [PMID: 38811649 PMCID: PMC11137072 DOI: 10.1038/s41598-024-62845-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024] Open
Abstract
Comparison of the three methods standing-on-a-stool (SS), one knee kneeling on a stretcher (KS), and kneeling at the same height as the patient's bed on the kneeling stool (KK) to evaluate the yielded of highest CPR quality and rescuer comfortability. A prospective randomized cross-over study which compares the three different rescuer positions for their effectiveness of chest compression. Conducted at a tertiary care between 19 and 22 Aug 2022. Emergency personnel aged 18 years or older, who completed the AHA-approved BLS course. The chest compression data was obtained by the ALIVE AED manikin® and AED reporting system. The information on the CPR quality and post-test questionnaires assessing the participants' preference, satisfaction and modified Borg's scale score was collected. The three methods shown no statistically significant difference in adequate chest compression depth (percentage). KK was not superior than SS at chest compression rate (P = 0.05). The adequate full chest recoil achieved with KK and KS were significantly higher than that of SS. However, there were no statistical difference between the three methods in the modified Borg's scale score. Based on the satisfying score, the rescuers preferred KK to either SS (p 0.007) or KS (p 0.012). The three methods shown no statistically significant difference in adequate chest compression depth (percentage). Still, both KK and KS provided more adequate chest recoil, so we would recommend using these two methods in the ED.Clinical trial registry: This study was retrospective registration in thaiclinicaltrials.org (TCTR20230119002, 19/1/2023).
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Affiliation(s)
- Nawaphon Charungwatthana
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Sribhumi, Amphoe Muang Chiang Mai, Chiang Mai, 50200, Thailand
| | - Pavita Laohakul
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Sribhumi, Amphoe Muang Chiang Mai, Chiang Mai, 50200, Thailand
| | - Theerapon Tangsuwanaruk
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Sribhumi, Amphoe Muang Chiang Mai, Chiang Mai, 50200, Thailand
| | - Borwon Wittayachamnankul
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawaroros Road, Sribhumi, Amphoe Muang Chiang Mai, Chiang Mai, 50200, Thailand.
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Parent-Nichols J, Perez J, Witherell B, McWilliam P, Halamek LP, Kent N, Varnum W, Yamada NK. Impact of bed height on the biomechanics of healthcare professionals during chest compressions on the neonate: a descriptive pilot study. BMJ Open 2021; 11:e047666. [PMID: 34531209 PMCID: PMC8449956 DOI: 10.1136/bmjopen-2020-047666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The biomechanics of the healthcare professionals (HCPs) performing the life-saving intervention of chest compressions in the neonatal population is poorly understood. The aim of this pilot study was to describe the variations in body position at a self-selected and a predetermined bed height during neonatal chest compressions. Measures of joint angles, time to postural sway and number of postural adjustments were chosen as indices for the stability of the HCP's position. SETTING Data were collected at a simulation-based research centre in which the patient care environment was replicated. PARTICIPANTS HCPs with varying roles working in the neonatal intensive care unit and holding a current Neonatal Resuscitation Program Provider certification were recruited for this study. INTERVENTIONS Fifteen HCPs performed two trials of chest compressions, each lasting 2 min, at a predetermined bed height and a self-selected bed height. Trials were video recorded, capturing upper and lower body movements. Videos were analysed for time to postural sway and number of postural adjustments. Joint angles were measured at the start and end of each trial. RESULTS A statistically significant difference was found between the two bed height conditions for number of postural adjustments (p=0.02). While not statistically significant, time postural sway was increased in the choice bed height condition (85 s) compared with the predetermined bed height (45 s). After 30 s of chest compressions, mean shoulder and knee angles were smaller for choice bed height (p=0.03, 95% CI Lower=-12.14, Upper=-0.68 and p=0.05, 95% CI Lower=3.43, Upper=0.01, respectively). After 1 min and 45 s of chest compressions, mean wrist angles were smaller in the choice bed height condition (p=0.01, 95% CI Lower=-9.20, Upper=-1.22), stride length decreased between the 30 s and 1 min 45 s marks of the chest compressions in the predetermined height condition (p=0.02).
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Affiliation(s)
- Jennifer Parent-Nichols
- Doctor of Physical Therapy Program, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Julia Perez
- Physical Therapy, The Spine and Health Center of Montvale, Montvale, New Jersey, USA
| | - Brittany Witherell
- Physical Therapy, Elliot Physical Therapy, Dorchester, Massachusetts, USA
| | - Paula McWilliam
- Nursing, Franklin Pierce University, Manchester, New Hampshire, USA
| | - Louis P Halamek
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Nancy Kent
- Nursing, Franklin Pierce University, Manchester, New Hampshire, USA
| | - Wendy Varnum
- Nursing, Franklin Pierce University, Manchester, New Hampshire, USA
| | - Nicole K Yamada
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
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Effect of the Use of Metronome Feedback on the Quality of Pediatric Cardiopulmonary Resuscitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158087. [PMID: 34360379 PMCID: PMC8345427 DOI: 10.3390/ijerph18158087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/11/2022]
Abstract
Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.
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Ho CS, Hsu YJ, Li F, Tang CC, Yang CP, Huang CC, Ho CS, Chang CH. Effect of Ambulance Stretcher Bed Height Adjustment on CPR Quality and Rescuer Fatigue in a Laboratory Environment. Int J Med Sci 2021; 18:2783-2788. [PMID: 34220306 PMCID: PMC8241775 DOI: 10.7150/ijms.59037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/10/2021] [Indexed: 11/05/2022] Open
Abstract
Background: The quality of cardiopulmonary resuscitation (CPR) is closely related to the survival rate of a patient, and it is crucial to maintain the quality of CPR during the ambulance journey to the receiving hospital. The purpose of this study was to investigate the effects of different stretcher bed heights on operator CPR quality. Methods: In this randomized crossover trial, 16 male emergency medical technicians-paramedics (EMT-Ps) performed continuous chest compressions on a hemimorphic mannequin for 5 minutes, alternating between the current height of the stretcher bed on the ambulance (38 ± 1 cm) (S-38) and the height of the participant's midpoint of the patella (S-knee), where the stretcher bed surface is. Results: According to the analysis of the quality of CPR exercises with two different stretcher bed heights at 5 minutes of continuous chest compression, the mean chest compression depth (CCD) of the S-38 position (53.81 ± 1.91 cm) was significantly lower than that of the S-knee (55.12 ± 2.03 cm; p < 0.001). The mean chest compression rate (CCR) of the S-38 position (111.44 ± 3.44 beats/min) was significantly higher than that of the S-knee (109.63 ± 4.46 beats/min; p = 0.027). The mean of total chest compressions (TCC) of the S-38 position (557.44 ± 16.81 times) was significantly higher than that of the S-knee (548.24 ± 19.40 times; p = 0.029). The rating of perceived exertion (RPE) of the S-38 position was significantly higher than that of the S-knee (12.75 ± 1.91 %; p = 0.015). Only the chest compression rebound rate (CCRR) (S-38: 97.56 ± 4.63 % vs. S-knee: 98.31 ± 1.89 %, p = 0.401) and the chest compression fraction (CCF) (S-38: 98.44 ± 0.81 % vs. S-knee: 98.44 ± 0.96 %, p = 1.000) did not reach a significant difference. Conclusion: When a resuscitator is performing chest compressions in a standing position in an ambulance, the excessive downward leaning of the resuscitator's upper body affects CPR quality and increases fatigue. This study has verified that setting the stretcher bed of the ambulance at the knee height of the EMTs provides better CPR quality and lower fatigue.
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Affiliation(s)
- Chun-Sheng Ho
- Department of Physical Therapy, College of Medical and Health Science, Asia University, Taichung City, Taiwan.,Division of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan City, Taiwan
| | - Yi-Ju Hsu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Fang Li
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Chien-Ching Tang
- College of Exercise and Health Science, National Taiwan Sport University, Taoyuan City, Taiwan.,First Corps, Fire Department, New Taipei City Government, New Taipei City, Taiwan
| | - Cheng-Pang Yang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan.,Department of Orthopedic Surgery, Chang Gung memorial hospital, Linkou Branch, Taoyuan City, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Chun-Hao Chang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, Taiwan
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Oh JH. Differences in the effects of rescuers' height and weight on adult and paediatric resuscitation. Acta Paediatr 2020; 109:1909. [PMID: 32163621 DOI: 10.1111/apa.15252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Je Hyeok Oh
- Department of Emergency Medicine Chung‐Ang University College of Medicine Seoul Korea
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Ergonomic Challenges Inherent in Neonatal Resuscitation. CHILDREN-BASEL 2019; 6:children6060074. [PMID: 31163596 PMCID: PMC6617094 DOI: 10.3390/children6060074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 11/17/2022]
Abstract
Neonatal resuscitation demands that healthcare professionals perform cognitive and technical tasks while working under time pressure as a team in order to provide efficient and effective care. Neonatal resuscitation teams simultaneously process and act upon multiple data streams, perform ergonomically challenging technical procedures, and coordinate their actions within a small physical space. An understanding and application of human factors and ergonomics science broadens the areas of need in resuscitation research, and will lead to enhanced technologies, systems, and work environments that support human limitations and maximize human performance during neonatal resuscitation.
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Oh JH. Does the use of steps decrease the quality of cardiopulmonary resuscitation when children as rescuers perform chest compression? Am J Emerg Med 2019; 37:155-156. [DOI: 10.1016/j.ajem.2018.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 05/12/2018] [Indexed: 11/30/2022] Open
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How can we administer high-quality chest compressions to a cardiac arrest patient on a bed? Am J Emerg Med 2018; 36:715-716. [PMID: 29395776 DOI: 10.1016/j.ajem.2018.01.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/25/2018] [Indexed: 11/24/2022] Open
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Mygind-Klausen T, Krogh K, Løfgren B. How can we administer high-quality chest compressions to a cardiac arrest patient on a bed? Am J Emerg Med 2018; 36:716-717. [PMID: 29397256 DOI: 10.1016/j.ajem.2018.01.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/25/2018] [Indexed: 10/18/2022] Open
Affiliation(s)
- Troels Mygind-Klausen
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark
| | - Kristian Krogh
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark.
| | - Bo Løfgren
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd. 99, 8200 Aarhusv, Denmark.
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Oh JH. Potential pros and cons of the kinect-based real-time audiovisual feedback device during in-hospital cardiopulmonary resuscitation. Am J Emerg Med 2018; 36:319-320. [DOI: 10.1016/j.ajem.2017.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022] Open
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Reply to letter, “Potential pros and cons of the Kinect-based real-time audiovisual feedback device during in-hospital CPR”. Am J Emerg Med 2018; 36:320. [DOI: 10.1016/j.ajem.2017.11.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 11/13/2017] [Indexed: 11/20/2022] Open
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Mygind-Klausen T, Jæger A, Hansen C, Aagaard R, Krogh LQ, Nebsbjerg MA, Krogh K, Løfgren B. In a bed or on the floor? - The effect of realistic hospital resuscitation training: A randomised controlled trial. Am J Emerg Med 2017; 36:1236-1241. [PMID: 29276031 DOI: 10.1016/j.ajem.2017.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION In-hospital cardiac arrest has a poor prognosis and often occurs in patients lying in a hospital bed. A bed mattress is a soft compressible surface that may decrease cardiopulmonary resuscitation (CPR) quality. Often hospital CPR training is performed with a manikin on the floor. AIM To study CPR quality following realistic CPR training with a manikin in a bed compared with one on the floor. METHODS We conducted a randomised controlled study. Healthcare professionals were randomised to CPR training with a manikin in a hospital bed or one on the floor. Data on CPR quality was collected from manikins. The primary outcome measure was chest compression depth. RESULTS In total, 108 healthcare professionals (age: 40years, female: 94%) were included. The mean chest compression depth was 39mm (standard deviation (SD): 10), for the bed group compared with 38mm (SD: 9) for the floor group, p=0.49. A post hoc analysis showed that regardless of the training method, the participants who optimised their working position by jumping onto the bed or lowering the bed had a median chest compression depth of 39mm (25th-75th percentiles: 33-45) compared with 29mm (25th-75th percentiles: 23-41) for participants who did neither, p=0.04. CONCLUSION There was no significant difference in chest compression depth between healthcare professionals who trained CPR on a manikin in a hospital bed compared with one on the floor. Chest compression depth was too shallow in both groups. Irrespective of the training method, participants who optimised their working position performed deeper chest compressions.
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Affiliation(s)
- Troels Mygind-Klausen
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
| | - André Jæger
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
| | - Camilla Hansen
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
| | - Rasmus Aagaard
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark.
| | - Lise Qvirin Krogh
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark.
| | - Mette Amalie Nebsbjerg
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark.
| | - Kristian Krogh
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark.
| | - Bo Løfgren
- Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 1B, 8000 Aarhus C, Denmark; Department of Internal Medicine and Clinical Research Unit, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NE, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd. 99, 8200 Aarhus N, Denmark.
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Oh JH, Kim CW, Kim SE, Lee DH. Does the Bed Frame Deflection Occur along with Mattress Deflection during In-Hospital Cardiopulmonary Resuscitation? an Experiment Using Mechanical Devices. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives When we perform chest compression on a patient on a bed, the mattress and bed frame can be depressed together with the patient's chest. This study was conducted to assess whether bed frame deflection occurred during chest compressions. Methods We designed a firm bed (“bed like the ground,” BLG) to assess the bed frame deflection in the Stryker Trauma Stretcher (STS) and the ER stretcher cart (ER-SC). The STS included a soft mattress and the ER-SC a hard mattress. We performed 50 continuous chest compressions on the Resusci Anne Skill Reporter with CPRmeter in each experiment. The experiments were done in four settings. Test 1 included the BLG; test 2 included a mattress and backboard on each bed; test 3 included the mattress of each bed and a backboard on the BLG; and test 4 included the mattress of each bed on the BLG. We calculated the mattress and bed frame deflections using the gaps of compression depths between the values measured by Resusci Anne and CPRmeter. Results The mattress deflections of the STS and ER-SC mattress were determined to be 11.2 and 0.67 mm, respectively. The bed frame deflection for the STS and ER-SC were 0.95 and 5.17 mm, respectively. Conclusion The study confirms that bed frame deflection will occur when we perform chest compressions on the manikin lying on a bed. Additionally, the bed frame deflections differ depending on the type of bed. (Hong Kong j.emerg.med. 2016;23:35-41)
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Kim CH, Kim GW. The Efficacy of Alternative Cardiopulmomonary Resuscitation Methods When Compared to Standard Cardiopulmonary Resuscitation: A Simulation Study. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791201900402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective There are limited data comparing the alternative cardiopulmomary resuscitation (CPR) methods (over the head CPR, straddle CPR and one hand CPR) to standard CPR performed by emergency medical technicians (EMTs). Therefore we investigated the efficacy of the alternative CPRs compared to that of standard CPR performed by EMTs in simulated cardiac arrest scenarios. Methods Thirty EMTs of intermediate level participated in this study. The performance of CPR was defined as the average depth, the total number of chest compressions, and the rate of compressions. EMTs performed three minutes of standard CPR and of alternative CPR on standard simulation mannequins with recording devices. Recorded performance was measured and compared between subgroups by the type of CPR, gender of EMTs and gender with various methods of CPR using ANOVA and t test statistics. Results The average depth of compressions was 42.3±5.8, 42.6±4.7, 43.5±3.7, 33.8±6.6 mm (mean±standard deviation) respectively in standard CPR, over the head CPR, straddle CPR and one hand CPR. The total number of chest compression was 330.4±38.1, 334.8±70.2, 334.0±34.9, 312.1±53.5 in 3 minutes. The rate of compressions was found to be 111.5±10.3, 113.8±11.6, 110.5±11.2, 110.7±11.8 times per minute. The comparison of the performance qualities for the four types of CPR showed that the compression depth was significantly lower in one-hand CPR (p<0.000). No EMT gender difference in the quality of performance of total CPR was noted. Conclusions The efficacy of alternative CPRs are shown to be similar to that of standard CPR in a compression-only simulation cardiac arrest model.
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Affiliation(s)
- CH Kim
- Inje University College of Medicine and SeoulPaik Hospital, Department of Emergency Medicine, 85, 2-ga, Jeo-dong, Jung-Gu, Seoul 100-032, Korea
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Peltonen LM, Peltonen V, Salanterä S, Tommila M. Development of an instrument for the evaluation of advanced life support performance. Acta Anaesthesiol Scand 2017; 61:1215-1231. [PMID: 28832902 DOI: 10.1111/aas.12960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/08/2017] [Accepted: 07/21/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Assessing advanced life support (ALS) competence requires validated instruments. Existing instruments include aspects of technical skills (TS), non-technical skills (NTS) or both, but one instrument for detailed assessment that suits all resuscitation situations is lacking. This study aimed to develop an instrument for the evaluation of the overall ALS performance of the whole team. METHODS This instrument development study had four phases. First, we reviewed literature and resuscitation guidelines to explore items to include in the instrument. Thereafter, we interviewed resuscitation team professionals (n = 66), using the critical incident technique, to determine possible additional aspects associated with the performance of ALS. Second, we developed an instrument based on the findings. Third, we used an expert panel (n = 20) to assess the validity of the developed instrument. Finally, we revised the instrument based on the experts' comments and tested it with six experts who evaluated 22 video recorded resuscitations. RESULTS The final version of the developed instrument had 69 items divided into adherence to guidelines (28 items), clinical decision-making (5 items), workload management (12 items), team behaviour (8 items), information management (6 items), patient integrity and consideration of laymen (4 items) and work routines (6 items). The Cronbach's α values were good, and strong correlations between the overall performance and the instrument were observed. CONCLUSION The instrument may be useful for detailed assessment of the team's overall performance, but the numerous items make the use demanding. The instrument is still under development, and more research is needed to determine its psychometric properties.
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Affiliation(s)
- L.-M. Peltonen
- Department of Nursing Science; University of Turku; Turku Finland
- Intensive Care Unit; Turku University Hospital; Turku Finland
| | - V. Peltonen
- Department of Clinical Medicine; University of Turku; Turku Finland
- Department of Anesthesia and Intensive Care; Satakunta Central Hospital; Pori Finland
| | - S. Salanterä
- Department of Nursing Science; University of Turku; Turku Finland
- Developmental Services; Turku University Hospital; Turku Finland
| | - M. Tommila
- Division of Perioperative Services; Intensive Care Medicine and Pain Management; Turku University Hospital; Turku Finland
- Department of Anesthesiology and Intensive Care; University of Turku; Turku Finland
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17
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The effect of hydraulic bed movement on the quality of chest compressions. Am J Emerg Med 2017; 35:1075-1077. [PMID: 28274711 DOI: 10.1016/j.ajem.2017.02.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 02/23/2017] [Accepted: 02/25/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The hydraulic height control systems of hospital beds provide convenience and shock absorption. However, movements in a hydraulic bed may reduce the effectiveness of chest compressions. This study investigated the effects of hydraulic bed movement on chest compressions. MATERIALS AND METHODS Twenty-eight participants were recruited for this study. All participants performed chest compressions for 2min on a manikin and three surfaces: the floor (Day 1), a firm plywood bed (Day 2), and a hydraulic bed (Day 3). We considered 28 participants of Day 1 as control and each 28 participants of Day 2 and Day 3 as study subjects. The compression rates, depths, and good compression ratios (>5-cm compressions/all compressions) were compared between the three surfaces. RESULTS When we compared the three surfaces, we did not detect a significant difference in the speed of chest compressions (p=0.582). However, significantly lower values were observed on the hydraulic bed in terms of compression depth (p=0.001) and the good compression ratio (p=0.003) compared to floor compressions. When we compared the plywood and hydraulic beds, we did not detect significant differences in compression depth (p=0.351) and the good compression ratio (p=0.391). CONCLUSIONS These results indicate that the movements in our hydraulic bed were associated with a non-statistically significant trend towards lower-quality chest compressions.
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Zhou XL, Sheng LP, Wang J, Li SQ, Wang HL, Ni SZ, Jiang S, Zhao Y, Shen J, Yang QS. Effect of bed width on the quality of compressions in simulated resuscitation: a randomized crossover manikin study. Am J Emerg Med 2016; 34:2272-2276. [PMID: 27592725 DOI: 10.1016/j.ajem.2016.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/09/2016] [Accepted: 08/09/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To investigate the effects of bed width on the quality of chest compressions during simulated in-hospital resuscitation. METHODS Each candidate performed two 2-minute cycles of compression-only cardiopulmonary resuscitation on an adult manikin placed on either an emergency stretcher (narrow bed) or a standard hospital bed (wide bed) in random order at 1 day intervals. We conducted subjective assessments of cardiopulmonary resuscitation quality and rescuer fatigue at the end of each session, using surveys. RESULTS There were no significant differences between narrow and wide bed sessions in either mean depth or the percentage of compressions with adequate depth (P=.56 and .58, respectively). The mean rate of compressions and the percentage of compressions with adequate rate were also similar between sessions (P=.24 and .27, respectively). However, the percentage of correct hand position and complete chest recoil was significantly higher in the narrow bed session than in the wide bed session (P=.02 and .02, respectively). In addition, survey results showed that rescuers felt more comfortable and less exhausted in the narrow bed session compared with the wide bed session (P<.001 and < .001). CONCLUSIONS When rescuers performed chest compressions on an emergency stretcher, chest compression quality increased, and the fatigue of rescuers decreased compared with a standard hospital bed. Therefore, we propose a narrow bed for critically ill inpatients with high risk of cardiac arrest.
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Affiliation(s)
- Xian-Long Zhou
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
| | - Li-Ping Sheng
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
| | - Jing Wang
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
| | - Shun-Qing Li
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
| | - Huang-Lei Wang
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
| | - Shao-Zhou Ni
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
| | - Shan Jiang
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
| | - Yan Zhao
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China.
| | - Jun Shen
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
| | - Qi-Sheng Yang
- Emergency Centre, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, 430071, China
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Russi CS, Myers LA, Kolb LJ, Lohse CM, Hess EP, White RD. A Comparison of Chest Compression Quality Delivered During On-Scene and Ground Transport Cardiopulmonary Resuscitation. West J Emerg Med 2016; 17:634-9. [PMID: 27625733 PMCID: PMC5017853 DOI: 10.5811/westjem.2016.6.29949] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/11/2016] [Accepted: 06/04/2016] [Indexed: 11/16/2022] Open
Abstract
Introduction American Heart Association (AHA) guidelines recommend cardiopulmonary resuscitation (CPR) chest compressions 1.5 to 2 inches (3.75–5 cm) deep at 100 to 120 per minute. Recent studies demonstrated that manual CPR by emergency medical services (EMS) personnel is substandard. We hypothesized that transport CPR quality is significantly worse than on-scene CPR quality. Methods We analyzed adult patients receiving on-scene and transport chest compressions from nine EMS sites across Minnesota and Wisconsin from May 2008 to July 2010. Two periods were analyzed: before and after visual feedback. CPR data were collected and exported with the Zoll M series monitor and a sternally placed accelerometer measuring chest compression rate and depth. We compared compression data with 2010 AHA guidelines and Zoll RescueNet Code Review software. CPR depth and rate were “above (deep),” “in,” or “below (shallow)” the target range according to AHA guidelines. We paired on-scene and transport data for each patient; paired proportions were compared with the nonparametric Wilcoxon signed rank test. Results In the pre-feedback period, we analyzed 105 of 140 paired cases (75.0%); in the post-feedback period, 35 of 140 paired cases (25.0%) were analyzed. The proportion of correct depths during on-scene compressions (median, 41.9%; interquartile range [IQR], 16.1–73.1) was higher compared to the paired transport proportion (median, 8.7%; IQR, 2.7–48.9). Proportions of on-scene median correct rates and transport median correct depths did not improve in the post-feedback period. Conclusion Transport chest compressions are significantly worse than on-scene compressions. Implementation of visual real-time feedback did not affect performance.
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Affiliation(s)
| | | | - Logan J Kolb
- Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota
| | - Christine M Lohse
- Mayo Clinic, Division of Biomedical Statistics and Informatics, Rochester, Minnesota
| | - Erik P Hess
- Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota; Mayo Clinic, Division of Health Care Policy and Research, Rochester, Minnesota
| | - Roger D White
- Mayo Clinic, Division of Cardiovascular and Thoracic Anesthesia, Division of Cardiovascular Diseases, Rochester, Minnesota
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20
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Cheong SA, Oh JH, Kim CW, Kim SE, Lee DH. Effects of alternating hands during in-hospital one-handed chest compression: A randomised cross-over manikin trial. Emerg Med Australas 2015; 27:567-572. [DOI: 10.1111/1742-6723.12492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Sin Ae Cheong
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
| | - Je Hyeok Oh
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
| | - Chan Woong Kim
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
| | - Sung Eun Kim
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
| | - Dong Hoon Lee
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Republic of Korea
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21
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Jung MH, Oh JH, Kim CW, Kim SE, Lee DH, Chang WJ. Does accelerometer feedback on high-quality chest compression improve survival rate? An in-hospital cardiac arrest simulation. Am J Emerg Med 2015; 33:993-7. [DOI: 10.1016/j.ajem.2015.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 04/08/2015] [Accepted: 04/09/2015] [Indexed: 11/26/2022] Open
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22
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Oh JH, Kim SE, Kim CW, Lee DH. Should we change chest compression providers every 2 min when performing one-handed chest compressions? Emerg Med Australas 2015; 27:108-12. [DOI: 10.1111/1742-6723.12364] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Je Hyeok Oh
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Korea
| | - Sung Eun Kim
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Korea
| | - Chan Woong Kim
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Korea
| | - Dong Hoon Lee
- Department of Emergency Medicine; College of Medicine; Chung-Ang University; Seoul Korea
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23
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Oh J, Chee Y, Lim T, Cho Y, Kim IY. Chest compression with kneeling posture in hospital cardiopulmonary resuscitation: A randomised crossover simulation study. Emerg Med Australas 2014; 26:585-90. [DOI: 10.1111/1742-6723.12307] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Jaehoon Oh
- Department of Emergency Medicine; College of Medicine; Hanyang University; Seoul Korea
| | - Youngjoon Chee
- School of Electrical Engineering; University of Ulsan; Ulsan Korea
| | - Taeho Lim
- Department of Emergency Medicine; College of Medicine; Hanyang University; Seoul Korea
| | - Youngsuk Cho
- Department of Emergency Medicine; College of Medicine; Hallym University; Seoul Korea
| | - In Young Kim
- Department of Biomedical Engineering; College of Medicine; Hanyang University; Seoul Korea
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24
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Yun SW, Lee BK, Jeung KW, Park SW, Choi SS, Lee CH, Ryu SY. The effect of inclined step stool on the quality of chest compression during in-hospital cardiopulmonary resuscitation. Am J Emerg Med 2014; 32:851-5. [DOI: 10.1016/j.ajem.2014.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 11/25/2022] Open
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25
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Hong CK, Park SO, Jeong HH, Kim JH, Lee NK, Lee KY, Lee Y, Lee JH, Hwang SY. The most effective rescuer's position for cardiopulmonary resuscitation provided to patients on beds: a randomized, controlled, crossover mannequin study. J Emerg Med 2013; 46:643-9. [PMID: 24262059 DOI: 10.1016/j.jemermed.2013.08.085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 06/10/2013] [Accepted: 08/16/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The effectiveness of chest compressions for cardiopulmonary resuscitation (CPR) is affected by the rescuer's position with respect to the patient. In hospitals, chest compressions are typically performed while standing beside the patient, who is placed on a bed. STUDY OBJECTIVES To compare the effectiveness of chest compressions, performed on a bed during 2 min of CPR, among three different rescuer positions: standing, on a footstool, or kneeling on the bed. METHODS We performed a crossover randomized simulation trial. Participants were recruited from among students in the Department of Paramedics from July to August 2011. Thirty-eight participants were enrolled, and they performed chest compressions on a mannequin for 2 min in each of the three different positions, with a 1-week interval between each position. RESULTS The number of adequate compressions (depth > 50 mm) and the mean compression depth were significantly greater in the kneeling and footstool positions than in the standing position, but there was no significant difference between the kneeling and footstool positions. There were no significant differences in the compression rate, the percentage of correctly released compressions, and the percentage of compressions performed using the correct hand position among the three rescuer positions. CONCLUSION The mean compression depth and the number of adequate compressions were greater for both the kneeling and footstool positions than for the standing position during 2 min of CPR. We recommend kneeling on a bed or standing on a footstool as the rescuer positions during hospital CPR on a bed.
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Affiliation(s)
- Chong Kun Hong
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Changwon, Republic of Korea; Department of Emergency Medicine, Daejin Medical Center, Bundang Jesaeng General Hospital, Sungnam, Republic of Korea
| | - Sang O Park
- Department of Emergency Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Han Ho Jeong
- Department of Emergency Medical Technology, Masan University, Changwon, Republic of Korea
| | - Jung Hyun Kim
- Department of Emergency Medical Technology, Masan University, Changwon, Republic of Korea
| | - Na Kyoung Lee
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Changwon, Republic of Korea
| | - Kyoung Yul Lee
- Department of Physical Education, Kyungnam University, Changwon, Republic of Korea
| | - Younghwan Lee
- Department of Emergency Medicine, Hallym Sacred Heart Hospital, School of Medicine, Hallym University, Anyang, Republic of Korea
| | - Jun Ho Lee
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Changwon, Republic of Korea
| | - Seong Youn Hwang
- Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Changwon, Republic of Korea
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26
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Brindley PG, Douma M. Resuscitation following penetrating abdominal and pelvic trauma: novel insights and useful reminders. Resuscitation 2013; 84:e147-8. [PMID: 23907099 DOI: 10.1016/j.resuscitation.2013.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 07/22/2013] [Indexed: 11/30/2022]
Affiliation(s)
- P G Brindley
- Division of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada
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Oh JH, Kim CW, Kim SE, Lee SJ, Lee DH. Comparison of chest compressions in the standing position beside a bed at knee level and the kneeling position: a non-randomised, single-blind, cross-over trial: Table 1. Emerg Med J 2013; 31:533-535. [DOI: 10.1136/emermed-2013-202443] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 03/21/2013] [Indexed: 11/04/2022]
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28
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Yasuda Y, Kato Y, Sugimoto K, Tanaka S, Tsunoda N, Kumagawa D, Toyokuni Y, Kubota K, Inaba H. Muscles used for chest compression under static and transportation conditions. PREHOSP EMERG CARE 2013; 17:162-9. [PMID: 23327531 DOI: 10.3109/10903127.2012.749964] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Unstable conditions during ambulance transportation are not conducive to the performance of high-quality cardiopulmonary resuscitation by emergency medical technicians. OBJECTIVE The present study was conducted to clarify differences in the quality of chest compression and associated muscle activity between static and ambulance transportation conditions. METHODS Nine paramedic students performed chest compression for 5 minutes on the floor and during ambulance transportation. Compression rate and depth and success and error rates of chest compression were determined using the Resusci Anne manikin with a PC SkillReporting System (Laerdal Medical). Integrated electromyography (i-EMG) values of eight different muscles were also recorded bilaterally during the first and last 30 seconds of compression. RESULTS There was no significant difference in compression rate per minute (p = 0.232) and depth of chest compression (p = 0.174) between the two conditions. The success rate was significantly lower under the ambulance transportation condition than under the static condition (p = 0.0161). Compared with those under the static condition, the total i-EMG values were significantly lower for the multifidus (p = 0.0072) and biceps femoris (p < 0.0001) muscles and significantly higher for the deltoid (p = 0.0032), pectoralis major (p = 0.0037), triceps brachii (p = 0.0014), vastus lateralis (p < 0.0001), and gastrocnemius (p = 0.0004) muscles under the ambulance transportation condition. CONCLUSIONS Chest compression is performed mainly through flexion and extension of the hip joint while kneeling on the floor and through the elbow and shoulder joints while standing in a moving ambulance. Therefore, the low quality of chest compression during ambulance transportation may be attributable to an altered technique of performing the procedure.
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Affiliation(s)
- Yasuharu Yasuda
- Faculty of Health Science, Hiroshima International University, Hiroshima, Japan.
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Lee DH, Kim CW, Kim SE, Lee SJ. Use of step stool during resuscitation improved the quality of chest compression in simulated resuscitation. Emerg Med Australas 2012; 24:369-73. [DOI: 10.1111/j.1742-6723.2012.01545.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Handley AJ. In-hospital chest compressions--the patient on a bed. Resuscitation 2012; 83:795-6. [PMID: 22445814 DOI: 10.1016/j.resuscitation.2012.03.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 03/15/2012] [Indexed: 11/18/2022]
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31
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Cho J, Oh JH. The importance of the bed height during in-hospital cardiopulmonary resuscitation. Resuscitation 2011; 82:634. [PMID: 21345569 DOI: 10.1016/j.resuscitation.2010.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 06/30/2010] [Indexed: 11/15/2022]
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