Cardio pump reloaded: in-hospital resuscitation during transport

Abstract

High-quality chest compressions are crucial during resuscitation if a positive outcome is to be achieved. Sometimes a patient must be transported within the hospital while chest compressions are being performed. We compared different chest compression devices [animax mono (AM), AutoPulse(®) (AP) and LUCAS2™ (L2)] with manual chest compression using a manikin during transport from a fifth floor ward to the cardiac catheterization laboratory in the basement. Chest compressions were interrupted for 10.7 s to set up the AM, 15.3 s for the L2 and 23.5 s for the AP. The use of a mechanical device reduced transport times from 144.5 s when manual compressions were underway, to 126.8, 111.1 and 98.5 s with the AM, L2 and AP, respectively (p < 0.05). Transfer to the laboratory gurney required little or no interruption in chest compressions with the L2 (0.8 s) and AP (no interruption), compared with 10.3 s with the AP and 3.3 s for manual compressions. Manual compression frequency was 124 min(-1), compared with 100.4 min(-1) for the AM, 99.9 min(-1) for the L2 and 79.7 min(-1) for the AP. Compression depth did not change during transport in any group. Mechanical compression devices are suitable for use during transport, but are not clearly superior to manual compressions. Devices maintain the same compression depth, but fell short of current guidelines, as did manual compressions. Some interruptions occurred while the devices were set up. Further, patient studies are necessary to determine the clinical utility of these devices.

Cardiopulmonary resuscitation is more effective for in-hospital cardiac arrest when performed on a stretcher

“…However, like the studies conducted by Gassler et al 9 and Ventzke et al, 10 the time from the start command to the first compression was longer than 10 seconds in the CPR-MCCD group. Compared to anesthesiology residents, emergency residents took less time to prepare the device.…”

“…2 For the CPR-S and CPR-W methods, the average number of compressions per minute was found to be higher than the numbers recommended in the ERC and AHA guidelines. Furthermore, Gassler et al 9 and Ventzke et al 10 found a significantly higher number of compressions per minute when comparing the efficacy of various MCCDs during patient transport. This was likely because it was difficult to concentrate on the number of compressions during dynamic patient transport.…”

“…3 Previous research has also suggested that MCCD could be an alternative for manual chest compressions during transport. 9,10 Studies regarding CPR during transport have mostly focused on OHCA; 6,9 therefore, there is a limited number of studies on IHCA cases. Furthermore, guidelines that allow practitioners to achieve the optimal chest compression quality have not been established.…”

Automatic and manual devices for cardiopulmonary resuscitation: A review

“…Transportation of patients in CPR in and out the hospital is a frequent contingency. Ventzke et al 65 compared the performance of Animax, LUCAS 2, AutoPulse, and manual CPR during the transportation of a manikin from the fifth floor to the basement of the same hospital. Unfortunately, they did not give information about the training of the staff involved in the trial.…”