Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-05T02:42:51.304Z Has data issue: false hasContentIssue false
  • English
  • Français

Can Correct Closed-Chest Compressions Be Performed During Prehospital Transport?

Published online by Cambridge University Press:  28 June 2012

C. Keith Stone  and
Stephen H. Thomas
C. Keith Stone*
Affiliation:
Department of Emergency Medicine, East CarolinaUniversity School of Medicine, Greenville, North Carolina
Stephen H. Thomas
Affiliation:
Department of Emergency Medicine, East CarolinaUniversity School of Medicine, Greenville, North Carolina
*
Department of Emergency Medicine, University of Kentucky, Lexington, KY 40536USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

The resuscitation rate from out-of-hospital cardiac arrest is low. There are many factors to be considered as contributing to this phenomenon. One factor not previously considered is the impact of a moving ambulance environment on the ability to perform closed-chest compressions.

Hypothesis:

Proper closed-chest compressions can be performed in a moving ambulance.

Methods:

A cardiopulmonary resuscitation (CPR) training mannequin with an attached skill meter (Skillmeter ResusciAnnie®, Laerdal, Armonk, N. Y., USA) that measures each chest compression for proper depth and hand placement was used. Ten emergency medical technician-basic (EMT-B) certified prehospital providers were assigned into one of five teams. Each team performed a total of four sessions of five minutes of continuous closed-chest compressions on the mannequin. Two sessions were done by each team: one in the control environment with the mannequin placed on the floor, and the other in the experimental environment with the mannequin placed in the back of a moving ambulance. The ambulance was operated without warning lights and siren, and all traffic rules were obeyed. The percentage of correct closed-chest compressions was recorded for each session, and the mean values were compared using Student's t-test with alpha set at 0.01 for statistical significance.

Results:

Ten sessions of compressions were done in both environments. The mean percentage of correct compressions was 77.6 ±15.6 for the control group and 45.6 ±18.3 for the ambulance group (p = 0.0005).

Conclusion:

A moving ambulance environment appears to impair the ability to perform closed-chest compressions.

Keywords

ambulancechest compressionsCPRemergency medical servicesmannequinprehospitaltransporttransportation of patients
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 10 , Issue 2 , June 1995 , pp. 121 - 123
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Presented at the National Association of EMS Physicians Annual Meeting, 11 June 1993, Minneapolis, Minnesota

References

1. Eisenberg, ES, Cummins, RO, Damon, S, et al. : Survival rates from out-of-hospital cardiac arrest: recommendations for uniform definitions and data to report. Ann Emerg Med 1990;19:1249–1259.CrossRefGoogle ScholarPubMed
2. Cummins, R, Ornato, J, Thies, W, et al. : The “chain of survival” concept. Circulation 1991;83:1832–1847.CrossRefGoogle Scholar
3. Ritter, G, Wolfe, RA, Goldstein, S, et al. : The effect of bystander CPR on survival of out-of-hospital cardiac arrest victims. Am Heart J 1985;110:932–937.CrossRefGoogle ScholarPubMed
4. Cummins, RO, Eisenberg, MS, Hallstrom, AP, et al. : Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med 1985;3:114–119.CrossRefGoogle ScholarPubMed
5. Cummins, RO: From concept to standard-of-care? Review of the clinical experience with automated external defibrillators. Ann Emerg Med 1989;18:1269–1275.CrossRefGoogle ScholarPubMed
6. Eisenberg, MS, Bergner, L, Hallstrom, A: Out-of-hospital cardiac arrest: Improved survival with paramedic services. Lancet 1980;1:812–815.CrossRefGoogle ScholarPubMed
7. Albarran-Sotelo, R, Flint, ES, Kelly, KJ: Healthcare Provider's Manual for Basic Life Support. Dallas, Texas: American Heart Association, 1988, pp 40–43.Google Scholar
8. van Stralen, D, Perkin, R, Barruga, M, et al. : Decrease in quality of CPR chest compressions during patient transports. Prehospital and Disaster Medicine 1992;7:27s. Abstract.Google Scholar
9. Paradis, NA, Martin, GB, Rivers, EP, et al. : Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA 1990;263:1106–1113.CrossRefGoogle ScholarPubMed
10. Cohen, TJ, Tucker, KJ, Lurie, KG, et al. : Active compression-decompression: A new method of cardiopulmonary resuscitation. JAMA 1992;267:2916–2923.CrossRefGoogle ScholarPubMed
11. Sack, JB, Kesselbrenner, MB, Bergman, D: Survival from in-hospital cardiac arrest with interposed abdominal counterpulsation during cardiopulmonary resuscitation. JAMA 1992;267:379–385.CrossRefGoogle ScholarPubMed