Effect of a dynamic mattress on chest compression quality during cardiopulmonary resuscitation

Abstract

Background: In-hospital cardiac arrest is a medical emergency that occurs on a regular basis. As patients most at risk for an in-hospital cardiac arrest are usually positioned on a dynamic mattress, it is important to measure the effect of mattress compressibility on chest compression quality during cardiopulmonary resuscitation (CPR).High-quality CPR is essential for patient survival and good neurological outcome. Aims and objectives: To examine the effect of an inflated dynamic overlay mattress on chest compression quality during CPR and to explore the predictive effect of health care providers' anthropometric factors, hand positioning and mattress type on chest compression frequency and depth. Design: Manikin-based single-blinded randomised controlled trial. Methods: Nursing students (N = 70) were randomised to a control (viscoelastic foam mattress) or intervention group (inflated dynamic overlay mattress on top of a viscoelastic foam mattress) and had to perform chest compressions over a 2-minute period. Compression rate, depth and hand positioning were registered. The 2015 European Resuscitation Council (ERC) guidelines were used as a reference.Results: The mean difference in chest compression depth between control and intervention groups was 2.86 mm (P = .043). Both groups met the guidelines for adequate chest compression quality, as recommended by the ERC. A predictive effect of health care providers' body height and weight, mattress type and hand positioning on compression depth could be demonstrated (P = .004).Conclusions: CPR in bedridden patients on a dynamic overlay mattress has a negative effect on the quality of chest compressions. Mean chest compression depth decreases significantly. However, clinical significance of the results may be debatable.

Spotlight on cardiac intensive care nursing

“…This issue includes a selection of papers on cardiac medical patients, 5–8 on post‐operative cardiac surgical patients 9–15 and on nurses' experiences and skills in delivering highly specialized extracorporeal membrane oxygenation (ECMO) treatment 16,17 . We also have an interesting paediatric paper examining the impact on red blood cells when delivered through infusion pumps 18 and a paper studying the impact of mattress type on the effectiveness of chest compressions, 19 concluding with a provocative critical commentary on oxygen saturation targets in COVID‐19 patients 20 . The studies adopted a broad range of quantitative and qualitative methodologies and were conducted in various countries spread across four continents (Kuwait, Iran, China, Malaysia, New Zealand, Israel, Italy, Spain, Belgium, the UK, and Brazil).…”