Maximilian Jörgens1, Jürgen Königer2, Karl-Georg Kanz3, Torsten Birkholz4, Heiko Hübner5, Stephan Prückner1, Bernhard Zwissler6, Heiko Trentzsch7. 1. Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, LMU München, Schillerstr. 53, 80336, München, Germany. 2. LAKUMED Klinken - Krankenhaus Vilsbiburg, Klinik für Anästhesie und Intensivmedizin, Vilsbiburg; Ärztlicher Leiter Rettungsdienst (ÄLRD), Landshut District, Germany. 3. Klinikum rechts der Isar der Technischen Universität München, Klinik und Poliklinik für Unfallchirurgie, München; Ärztlicher Bezirksbeauftragter Rettungsdienst (ÄBRD) Northwest Upper Bavaria, München, Germany. 4. Universitätsklinikum Erlangen, Anästhesiologische Klinik, Erlangen; former Ärztlicher Leiter Rettungsdienst (ÄLRD), Amberg District, Germany. 5. Medical Director of Emergency Services, Zweckverband für Rettungsdienst und Feuerwehralarmierung Allgäu, Kempten, Germany. 6. Klinik für Anästhesiologie, Klinikum der Universität München, LMU München, Munich, Germany. 7. Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, LMU München, Schillerstr. 53, 80336, München, Germany. heiko.trentzsch@med.uni-muenchen.de.
Abstract
BACKGROUND: Mechanical chest compression (mCPR) offers advantages during transport under cardiopulmonary resuscitation. Little is known how devices of different design perform en-route. Aim of the study was to measure performance of mCPR devices of different construction-design during ground-based pre-hospital transport. METHODS: We tested animax mono (AM), autopulse (AP), corpuls cpr (CC) and LUCAS2 (L2). The route had 6 stages (transport on soft stretcher or gurney involving a stairwell, trips with turntable ladder, rescue basket and ambulance including loading/unloading). Stationary mCPR with the respective device served as control. A four-person team carried an intubated and bag-ventilated mannequin under mCPR to assess device-stability (displacement, pressure point correctness), compliance with 2015 ERC guideline criteria for high-quality chest compressions (frequency, proportion of recommended pressure depth and compression-ventilation ratio) and user satisfaction (by standardized questionnaire). RESULTS: All devices performed comparable to stationary use. Displacement rates ranged from 83% (AM) to 11% (L2). Two incorrect pressure points occurred over 15,962 compressions (0.013%). Guideline-compliant pressure depth was > 90% in all devices. Electrically powered devices showed constant frequencies while muscle-powered AM showed more variability (median 100/min, interquartile range 9). Although physical effort of AM use was comparable (median 4.0 vs. 4.5 on visual scale up to 10), participants preferred electrical devices. CONCLUSION: All devices showed good to very good performance although device-stability, guideline compliance and user satisfaction varied by design. Our results underline the importance to check stability and connection to patient under transport.
BACKGROUND: Mechanical chest compression (mCPR) offers advantages during transport under cardiopulmonary resuscitation. Little is known how devices of different design perform en-route. Aim of the study was to measure performance of mCPR devices of different construction-design during ground-based pre-hospital transport. METHODS: We tested animax mono (AM), autopulse (AP), corpuls cpr (CC) and LUCAS2 (L2). The route had 6 stages (transport on soft stretcher or gurney involving a stairwell, trips with turntable ladder, rescue basket and ambulance including loading/unloading). Stationary mCPR with the respective device served as control. A four-person team carried an intubated and bag-ventilated mannequin under mCPR to assess device-stability (displacement, pressure point correctness), compliance with 2015 ERC guideline criteria for high-quality chest compressions (frequency, proportion of recommended pressure depth and compression-ventilation ratio) and user satisfaction (by standardized questionnaire). RESULTS: All devices performed comparable to stationary use. Displacement rates ranged from 83% (AM) to 11% (L2). Two incorrect pressure points occurred over 15,962 compressions (0.013%). Guideline-compliant pressure depth was > 90% in all devices. Electrically powered devices showed constant frequencies while muscle-powered AM showed more variability (median 100/min, interquartile range 9). Although physical effort of AM use was comparable (median 4.0 vs. 4.5 on visual scale up to 10), participants preferred electrical devices. CONCLUSION: All devices showed good to very good performance although device-stability, guideline compliance and user satisfaction varied by design. Our results underline the importance to check stability and connection to patient under transport.
Entities:
Keywords:
Cardio-pulmonary resuscitation; Device stability; Mechanical chest compressions; Pre-hospital emergency medical services; Transport
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