BACKGROUND: The quality of cardiopulmonary resuscitation (CPR) is important to survival after cardiac arrest. Mechanical devices (MD) provide constant CPR, but their effectiveness may be affected by deployment timeliness. OBJECTIVES: To identify the timeliness of the overall and of each essential step in the deployment of a piston-type MD during emergency department (ED) resuscitation, and to identify factors associated with delayed MD deployment by video recordings. METHODS: Between December 2005 and December 2008, video clips from resuscitations with CPR sessions using a MD in the ED were reviewed using time-motion analyses. The overall deployment timeliness and the time spent on each essential step of deployment were measured. RESULTS: There were 37 CPR recordings that used a MD. Deployment of MD took an average 122.6 ± 57.8s. The 3 most time-consuming steps were: (1) setting the device (57.8 ± 38.3s), (2) positioning the patient (33.4 ± 38.0 s), and (3) positioning the device (14.7 ± 9.5s). Total no flow time was 89.1 ± 41.2s (72.7% of total time) and associated with the 3 most time-consuming steps. There was no difference in the total timeliness, no-flow time, and no-flow ratio between different rescuer numbers, time of day of the resuscitation, or body size of patients. CONCLUSIONS: Rescuers spent a significant amount of time on MD deployment, leading to long no-flow times. Lack of familiarity with the device and positioning strategy were associated with poor performance. Additional training in device deployment strategies are required to improve the benefits of mechanical CPR.
BACKGROUND: The quality of cardiopulmonary resuscitation (CPR) is important to survival after cardiac arrest. Mechanical devices (MD) provide constant CPR, but their effectiveness may be affected by deployment timeliness. OBJECTIVES: To identify the timeliness of the overall and of each essential step in the deployment of a piston-type MD during emergency department (ED) resuscitation, and to identify factors associated with delayed MD deployment by video recordings. METHODS: Between December 2005 and December 2008, video clips from resuscitations with CPR sessions using a MD in the ED were reviewed using time-motion analyses. The overall deployment timeliness and the time spent on each essential step of deployment were measured. RESULTS: There were 37 CPR recordings that used a MD. Deployment of MD took an average 122.6 ± 57.8s. The 3 most time-consuming steps were: (1) setting the device (57.8 ± 38.3s), (2) positioning the patient (33.4 ± 38.0 s), and (3) positioning the device (14.7 ± 9.5s). Total no flow time was 89.1 ± 41.2s (72.7% of total time) and associated with the 3 most time-consuming steps. There was no difference in the total timeliness, no-flow time, and no-flow ratio between different rescuer numbers, time of day of the resuscitation, or body size of patients. CONCLUSIONS: Rescuers spent a significant amount of time on MD deployment, leading to long no-flow times. Lack of familiarity with the device and positioning strategy were associated with poor performance. Additional training in device deployment strategies are required to improve the benefits of mechanical CPR.
Authors: Benjamin S Abella; Nathan Sandbo; Peter Vassilatos; Jason P Alvarado; Nicholas O'Hearn; Herbert N Wigder; Paul Hoffman; Kathleen Tynus; Terry L Vanden Hoek; Lance B Becker Journal: Circulation Date: 2005-02-01 Impact factor: 29.690
Authors: Marcus Eng Hock Ong; Joseph P Ornato; David P Edwards; Harinder S Dhindsa; Al M Best; Caesar S Ines; Scott Hickey; Bryan Clark; Dean C Williams; Robert G Powell; Jerry L Overton; Mary Ann Peberdy Journal: JAMA Date: 2006-06-14 Impact factor: 56.272
Authors: Daniel M Rolston; Timmy Li; Casey Owens; Ghania Haddad; Timothy J Palmieri; Veronika Blinder; Jennifer L Wolff; Michael Cassara; Qiuping Zhou; Lance B Becker Journal: J Am Heart Assoc Date: 2020-03-10 Impact factor: 5.501