1.Simulation study on quality of CPR between manual chest compression and mechanical chest compression devices performed in ambulance
Tuan Hairulnizam Tuan Kamauzaman ; Johnny Ngu Tai Hock ; Ariff Arithra ; Abu Yazid Md Noh ; Siti-Azrin Ab Hamid ; Junainah Nor
The Medical Journal of Malaysia 2021;76(2):171-176
Background: Maintaining good quality CPR while
transporting out-of-hospital cardiac arrest patients is very
challenging. We aim to determine how different ambulance
speed can affect the quality of chest compression
performed either manually or mechanically.
Methods: This was an observational manikin-based study. A
total of 96 participants as well as two types of mechanical
compression devices: Lucas-2 and AutoPulse, performed
one minute of continuous chest compression on BT-CPEA
programmed manikin while the ambulance travelled at
different speeds, i.e., idle state, 30km/hr and 60km/hr. Seven
outcome variables of chest compression were measured.
Performance data of different groups of compressor were
compared and analysed using repeated measures analysis
of variance (ANOVA).
Results: In manual chest compression, significant variation
were noted among different speeds in term of average
compression rate (p<0.001), average compression depth
(p=0.007), fraction of adequate/insufficient compression
depth and fraction of normal hands positioning with
p=0.018, 0.022 and 0.034 respectively. Overall, AutoPulse
and Lucas-2 were not affected by ambulance speed. Lucas2 showed more consistent average compression rate, higher
fraction of adequate compression depth and reduced
fraction of insufficient compression depth as compared to
manual compression with p<0.001, 0.001 and 0.043
respectively.
Conclusion: In this study we found that ambulance speed
significantly affected certain aspects of manual chest
compression most notably compression depth, rate and
hand positioning. AutoPulse and Lucas-2 can improve these
aspects by providing more consistent compression rate,
depth and fraction of adequate compression depth during
transport.