Chest Compression Fraction between Mechanical Compressions on a Reducible Stretcher and Manual Compressions on a Standard Stretcher during Transport in Out-of-Hospital Cardiac Arrests: The Ambulance Stretcher Innovation of Asian Cardiopulmonary Resuscitation (ASIA-CPR) Pilot Trial.
Prehospital Emergency Care · 2017-01-01 · Quasi-experimental
Abstract
BACKGROUND: Cardiopulmonary resuscitation (CPR) with the use of mechanical devices is recommended during ambulance transport. However, the CPR quality en route and while in transfer to the emergency department (ED) for out-of-hospital cardiac arrests (OHCAs) remains uncertain. We developed a mechanical CPR device outfitted on a reducible stretcher (M-CPR) and compared with standard manual CPR on a standard stretcher (S-CPR) to evaluate CPR quality. METHODS: Adult OHCAs transported by five ambulances in a metropolitan area with a population of 3.5 million (many of whom lived in high-rise buildings) from September to October (before-phase) and November to December (after-phase) in 2015 were collected. The reducible stretcher was developed for use in a small elevator during the transfer from scene to ambulance, and the AutoPulse® (ZOLL Medical, Chelmsford, MA, USA) was used for M-CPR. Chest compression fraction (CCF) was measured by transthoracic impedance data using an X-series® cardiac monitor (ZOLL Medical) during time from attachment to patient to arrival to the ED. A comparison of CCF using a Wilcoxon signed-rank test evaluated the difference between the before- and after-phases. RESULTS: Of the eligible 49 OHCAs, 31 (21 in the before-phase and 10 in the after-phase) were analyzed, excluding patients for whom CCF was not measured, for whom M-CPR was not used, who had a return of spontaneous circulation in the field before transport, or who collapsed during transport. There were no differences in demographic data. Median total CCF (median, q1-q3) was significantly higher in the after-phase M-CPR group (85.2, 83.4-86.3) than in the before-phase S-CPR group (80.1, 68.0-85.2) (p = 0.03). CONCLUSION: Mechanical CPR on the reducible stretcher during the transport of OHCAs to the ED showed a much higher chest compression fraction than standard manual CPR.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mechanical CPR · Ambulance vehicle & crash safety · Patient handling equipment
Related articles
- CO2 and aerosol concentration during manual and mechanical chest compression while cardiopulmonary resuscitation. (Medicine (Baltimore), 2025)
- Children and Restraints Study in Emergency Ambulance Transport-Cardiopulmonary Resuscitation (CARSEAT-CPR): An Observational Cohort Study of a Simulated Pediatric Cardiac Arrest. (Pediatr Emerg Care, 2025)
- [Design and application of rescue stretcher dedicated for cardiopulmonary resuscitation mechanical compression device]. (Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2021)
- Simulation study on quality of CPR between manual chest compression and mechanical chest compression devices performed in ambulance. (Med J Malaysia, 2021)
- Cardiopulmonary resuscitation is more effective for in-hospital cardiac arrest when performed on a stretcher. A manikin study. (Saudi Med J, 2021)
- Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial. (Scand J Trauma Resusc Emerg Med, 2020)