Tyler Vadeboncoeur1, Uwe Stolz2, Ashish Panchal3, Annemarie Silver4, Mark Venuti5, John Tobin6, Gary Smith7, Martha Nunez8, Madalyn Karamooz9, Daniel Spaite10, Bentley Bobrow11. 1. Department of Emergency Medicine, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, United States. Electronic address: Vadeboncoeur.tyler@mayo.edu. 2. Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: ustolz@aemrc.arizona.edu. 3. Department of Emergency Medicine, The Ohio State University Wexner Medical Center ,760 Prior Hall 376 West 10th Avenue, Columbus, OH, 43210, United States. Electronic address: apanchal@aemrc.arizona.edu. 4. ZOLL Medical, 269 Mill Road, Chelmsford, MA 01824, United States. Electronic address: asilver@zoll.com. 5. Guardian Medical Transport, 1200 N Beaver Street, Flagstaff, AZ 86001, United States. Electronic address: mark.venuti@nahealth.com. 6. Mesa Fire and Medical Department, 13 W First Street, Mesa, AZ 85201, United States. Electronic address: johntobin@arizona.edu. 7. Mesa Fire and Medical Department, 13 W First Street, Mesa, AZ 85201, United States. Electronic address: garysmithmd@netscape.net. 8. Bureau of Emergency Medical Services, Arizona Department of Health Services, 150 N. 18th Avenue, #540, Phoenix, AZ 85007, United States. Electronic address: martha.nunez@azdhs.gov. 9. Arizona State University, Phoenix, AZ, United States. Electronic address: Madalyn821@gmail.com. 10. Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: dan@aemrc.arizona.edu. 11. Bureau of Emergency Medical Services, Arizona Department of Health Services, 150 N. 18th Avenue, #540, Phoenix, AZ 85007, United States; Maricopa Medical Center, Phoenix, AZ, United States; University of Arizona College of Medicine, Phoenix, AZ, United States. Electronic address: bobrowb@azdhs.gov.
Abstract
AIM: Outcomes from out-of-hospital cardiac arrest (OHCA) may improve if rescuers perform chest compressions (CCs) deeper than the previous recommendation of 38-51mm and consistent with the 2010 AHA Guideline recommendation of at least 51mm. The aim of this study was to assess the relationship between CC depth and OHCA survival. METHODS: Prospective analysis of CC depth and outcomes in consecutive adult OHCA of presumed cardiac etiology from two EMS agencies participating in comprehensive CPR quality improvement initiatives. ANALYSIS: Multivariable logistic regression to calculate adjusted odds ratios (aORs) for survival to hospital discharge and favorable functional outcome. RESULTS: Among 593 OHCAs, 136 patients (22.9%) achieved return of spontaneous circulation, 63 patients (10.6%) survived and 50 had favorable functional outcome (8.4%). Mean CC depth was 49.8±11.0mm and mean CC rate was 113.9±18.1CCmin(-1). Mean depth was significantly deeper in survivors (53.6mm, 95% CI: 50.5-56.7) than non-survivors (48.8mm, 95% CI: 47.6-50.0). Each 5mm increase in mean CC depth significantly increased the odds of survival and survival with favorable functional outcome: aORs were 1.29 (95% CI 1.00-1.65) and 1.30 (95% CI 1.00-1.70) respectively. CONCLUSION: Deeper chest compressions were associated with improved survival and functional outcome following OHCA. Our results suggest that adhering to the 2010 AHA Guideline-recommended depth of at least 51mm could improve outcomes for victims of OHCA.
AIM: Outcomes from out-of-hospital cardiac arrest (OHCA) may improve if rescuers perform chest compressions (CCs) deeper than the previous recommendation of 38-51mm and consistent with the 2010 AHA Guideline recommendation of at least 51mm. The aim of this study was to assess the relationship between CC depth and OHCA survival. METHODS: Prospective analysis of CC depth and outcomes in consecutive adult OHCA of presumed cardiac etiology from two EMS agencies participating in comprehensive CPR quality improvement initiatives. ANALYSIS: Multivariable logistic regression to calculate adjusted odds ratios (aORs) for survival to hospital discharge and favorable functional outcome. RESULTS: Among 593 OHCAs, 136 patients (22.9%) achieved return of spontaneous circulation, 63 patients (10.6%) survived and 50 had favorable functional outcome (8.4%). Mean CC depth was 49.8±11.0mm and mean CC rate was 113.9±18.1CCmin(-1). Mean depth was significantly deeper in survivors (53.6mm, 95% CI: 50.5-56.7) than non-survivors (48.8mm, 95% CI: 47.6-50.0). Each 5mm increase in mean CC depth significantly increased the odds of survival and survival with favorable functional outcome: aORs were 1.29 (95% CI 1.00-1.65) and 1.30 (95% CI 1.00-1.70) respectively. CONCLUSION: Deeper chest compressions were associated with improved survival and functional outcome following OHCA. Our results suggest that adhering to the 2010 AHA Guideline-recommended depth of at least 51mm could improve outcomes for victims of OHCA.
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