Estimating the impact of off-balancing forces upon cardiopulmonary resuscitation during ambulance transport

Kurz, Michael C.; Dante, Siddhartha; Puckett, Brian J.

doi:10.1016/j.resuscitation.2012.01.033

Cited by 27 publications

(17 citation statements)

References 23 publications

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“…143,144 There is no consensus on the ideal ambulance speed to address these concerns. 145,146 Studies of mechanical versus manual CPR in a moving ambulance show less effect on CPR quality when a mechanical device is used. 130,147 CPR and Systematic CQI Systematic CQI has optimized outcomes in a number of healthcare conditions, [22][23][24] increases safety, and reduces harm.…”

Section: Patient Transportmentioning

confidence: 99%

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Meaney¹,

Bobrow²,

Mancini³

et al. 2013

Circulation

864

521

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The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. As such, CPR quality varies widely between systems and locations. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient’s response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future.

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Section: Patient Transportmentioning

confidence: 99%

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Meaney¹,

Bobrow²,

Mancini³

et al. 2013

Circulation

864

521

View full text Add to dashboard Cite

show abstract

“…Relevant issues include the safety and logistics of longer prehospital transport time, the risk of rearrest and other adverse events, the negative impact of transport on CPR quality, and whether to bypass a local hospital or arrange for secondary transfer after stabilization at a local hospital. [52][53][54] Our review did not specifically investigate the impact of transport duration on patient outcomes but did include some studies that reported transport times. Using a mathematical model, Kragholm, et al concluded that there is survival benefit for cardiac arrest patients with prehospital ROSC to be transported to CAC even if journey time exceeds 20 minutes.…”

Section: Subgroup Analyses and Sensitivity Analysesmentioning

confidence: 99%

Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? — A systematic review

et al. 2019

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Please cite this article as: Yeung J, Matsuyama T, Bray J, Reynolds J, Skrifvars MB, Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? -A systematic review, Resuscitation (2019), https://doi.on behalf of the Education, Implementation and Team Task Force and Advanced Life Support Task Force of the International Liaison Committee on Resuscitation AIMTo perform a systematic review to answer 'In adults with attempted resuscitation after non-traumatic cardiac arrest does care at a specialised cardiac arrest centre (CAC) compared to care in a healthcare facility not designated as a specialised cardiac arrest centre improve patient outcomes?' METHODSThe PRISMA guidelines were followed. We searched bibliographic databases (Embase, MEDLINE and the Cochrane Library (CENTRAL)) from inception to 1 st August 2018. Randomised controlled trials (RCTs) and non-randomised studies were eligible for inclusion. Two reviewers independently scrutinized studies for relevance, extracted data and assessed quality of studies. Risk of bias of studies and quality of evidence were assessed using ROBINS-I tool and GRADEpro respectively. Primary outcomes were survival to 30 days with favourable neurological outcomes and survival to hospital discharge with favourable neurological outcomes. Secondary outcomes were survival to 30 days, survival to hospital discharge and return of spontaneous circulation (ROSC) post-hospital arrival for patients with ongoing resuscitation. This systematic review was registered in PROSPERO (CRD 42018093369) RESULTSWe included data from 17 observational studies on out-of-hospital cardiac arrest (OHCA) patients in meta-analyses. Overall, the certainty of evidence was very low. Pooling data from only adjusted analyses, care at CAC was not associated with increased likelihood of survival to 30 days with favourable neurological outcome (OR 2.92, 95%CI 0.68 to 12.48) and survival to 30 days (OR 2.14, 95%CI 0.73 to 6.29) compared to care at other hospitals. Whereas patients cared for at CACs had improved survival to hospital discharge with favourable neurological outcomes (OR 2.22, 95%CI 1.74 to 2.84) and survival to hospital discharge (OR 1.85, 95%CI 1.46 to 2.34). CONCLUSIONSVery low certainty of evidence suggests that post-cardiac arrest care at CACs is associated with improved outcomes at hospital discharge. There remains a need for high quality data to fully elucidate the impact of CACs.

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“…Previous studies have demonstrated the inability to provide high quality manual CPR during the extrication of patients on a stretcher, both down stairs and through confined corridors [7] . Additionally, adverse CPR quality has been recognised due to critical acceleration forces, occurring during ambulance transport, particularly at slower speeds [8] . As such, extrication and transportation to hospital may hinder resuscitation success versus remaining on scene [9] .…”

Section: Introductionmentioning

confidence: 99%

Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study

et al. 2018

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Estimating the impact of off-balancing forces upon cardiopulmonary resuscitation during ambulance transport

Cited by 27 publications

References 23 publications

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? — A systematic review

Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study

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