Protective athletic equipment slows initiation of CPR in simulated cardiac arrest

Rossi, Gianluca Del; Bodkin, Daniel; Dhanani, Aly; Courson, Ronald W.; Konin, Jeff G.

doi:10.1016/j.resuscitation.2011.02.022

Cited by 21 publications

(22 citation statements)

References 19 publications

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“…At a sporting event, athletic trainers are trained as first responders and therefore responsible for initiating CPR 21. The lives of athletes depend on athletic trainers because the first 10 min following cardiac arrest is crucial.…”

Section: Introductionmentioning

confidence: 99%

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CPR performance in the presence of audiovisual feedback or football shoulder pads

Tanaka

Rodrigues

Sotir

et al. 2017

BMJ Open Sport Exerc Med

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ObjectiveThe initiation of cardiopulmonary resuscitation (CPR) can be complicated by the use of protective equipment in contact sports, and the rate of success in resuscitating the patient depends on the time from incident to start of CPR. The aim of our study was to see if (1) previous training, (2) the presence of audiovisual feedback and (3) the presence of football shoulder pads (FSP) affected the quality of chest compressions.MethodsSix basic life support certified athletic training students (BLS-ATS), six basic life support certified emergency medical service personnel (BLS-EMS) and six advanced cardiac life support certified emergency medical service personnel (ACLS-EMS) participated in a crossover manikin study. A quasi-experimental repeated measures design was used to measure the chest compression depth (cm), rate (cpm), depth accuracy (%) and rate accuracy (%) on four different conditions by using feedback and/or FSP. Real CPR Help manufactured by ZOLL (Chelmsford, Massachusetts, USA) was used for the audiovisual feedback. Three participants from each group performed 2 min of chest compressions at baseline first, followed by compressions with FSP, with feedback and with both FSP and feedback (FSP+feedback). The other three participants from each group performed compressions at baseline first, followed by compressions with FSP+feedback, feedback and FSP.ResultsCPR performance did not differ between the groups at baseline (median (IQR), BLS-ATS: 5.0 (4.4–6.1) cm, 114(96–131) cpm; BLS-EMS: 5.4 (4.1–6.4) cm, 112(99–131) cpm; ACLS-EMS: 6.4 (5.7–6.7) cm, 138(113–140) cpm; depth p=0.10, rate p=0.37). A statistically significant difference in the percentage of depth accuracy was found with feedback (median (IQR), 13.8 (0.9–49.2)% vs 69.6 (32.3–85.8)%; p=0.0002). The rate accuracy was changed from 17.1 (0–80.7)% without feedback to 59.2 (17.3–74.3)% with feedback (p=0.50). The use of feedback was effective for depth accuracy, especially in the BLS-ATS group, regardless of the presence of FSP (median (IQR), 22.0 (7.3–36.2)% vs 71.3 (35.4–86.5)%; p=0.0002).ConclusionsThe use of audiovisual feedback positively affects the quality of the depth of CPR. Both feedback and FSP do not alter the rate measurements. Medically trained personnel are able to deliver the desired depth regardless of the presence of FSP even though shallower chest compressions depth can be seen in CPR with FSP. A feedback device must be introduced into the athletic training settings.

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Section: Introductionmentioning

confidence: 99%

“…Cardiopulmonary resuscitation performance is complicated, however, in equipment intensive sports such as American football. Quality of CPR with football shoulder pads (FSP) on and off were studied 21 23. Better CPR performance without FSP was reported 23.…”

Section: Introductionmentioning

confidence: 99%

CPR performance in the presence of audiovisual feedback or football shoulder pads

Tanaka

Rodrigues

Sotir

et al. 2017

BMJ Open Sport Exerc Med

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“…For the acute management of a patient with sudden cardiac arrest in an equipment-intensive sport, ATs must have clear instructions on what equipment should be removed before initiating CPR. Researchers [4][5][6] have explored the effects of football shoulder pads on compressions, and 1 group 6 examined how a football helmet affected ventilations, but to date, no published studies have assessed lacrosse equipment. Therefore, the purpose of our study was to determine the effect of men's lacrosse equipment on the performance of chest compressions and delivery of ventilations to a men's lacrosse athlete, as simulated by the Laerdal Resusci Anne.…”

Section: Discussionmentioning

confidence: 99%

“…Although a few authors [4][5][6] have examined how football equipment affects the delivery of CPR, no reports have been published on lacrosse equipment. Lacrosse shoulder pads are thinner and more flexible than football shoulder pads, and lacrosse helmets have a different shape and fit compared with football helmets.…”

mentioning

confidence: 99%

“…5,6 Whether the thinner pads used in lacrosse negatively affect compression quality is unknown, but evidence indicates that removing equipment delays the initiation of chest compressions. 4 Therefore, if optimal compression quality can be maintained, it may be preferable to deliver compressions over the equipment and delay equipment removal until an automated external defibrillator is ready to be applied. In addition to affecting chest compression quality, equipment may interfere with delivering ventilations.…”

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confidence: 99%

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Delivering Chest Compressions and Ventilations With and Without Men's Lacrosse Equipment

Clark

Davis

Petschauer

et al. 2018

Journal of Athletic Training

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Context: Current management recommendations for equipment-laden athletes in sudden cardiac arrest regarding whether to remove protective sports equipment before delivering cardiopulmonary resuscitation are unclear.Objective: To determine the effect of men's lacrosse equipment on chest compression and ventilation quality on patient simulators.Design: Cross-sectional study. Setting: Controlled laboratory.Patients or Other Participants: Twenty-six licensed athletic trainers (18 women, 8 men; age ¼ 25 6 7 years; experience ¼ 2.1 6 1.6 years).Intervention(s): In a single 2-hour session, participants were block randomized to 3 equipment conditions for compressions and 6 conditions for ventilations on human patient simulators.Main Outcome Measure(s): Data for chest compressions (mean compression depth, compression rate, percentage of correctly released compressions, and percentage of optimal compressions) and ventilations (ventilation rate, mean ventilation volume, and percentage of ventilations delivering optimal volume) were analyzed within participants across equipment conditions.Results: Keeping the shoulder pads in place reduced mean compression depth (all P values , .001, effect size ¼ 0.835) and lowered the percentages of both correctly released compressions (P ¼ .02, effect size ¼ 0.579) and optimal-depth compressions (all P values , .003, effect size ¼ 0.900). For both the bag-valve and pocket masks, keeping the chinstrap in place reduced mean ventilation volume (all P values , .001, effect size ¼ 1.323) and lowered the percentage of optimalvolume ventilations (all P values , .006, effect size ¼ 1.038). Regardless of equipment, using a bag-valve versus a pocket mask increased the ventilation rate (all P values , .003, effect size ¼ 0.575), the percentage of optimal ventilations (all P values , .002, effect size ¼ 0.671), and the mean volume (P ¼ .002, effect size ¼ 0.598) across all equipment conditions. Conclusions: For a men's lacrosse athlete who requires cardiopulmonary resuscitation, the shoulder pads should be lifted or removed to deliver chest compressions. The facemask and chinstrap, or the entire helmet, should be removed to deliver ventilations, preferably with a bag-valve mask.Key Words: sudden cardiac arrest, sudden death, emergency management, facemask, lacrosse helmet, simulation Key PointsLeaving the lacrosse helmets and shoulder pads in place decreased the quality of cardiopulmonary resuscitation. Removing the shoulder pads resulted in greater chest compression depth. Removing the helmet chinstrap increased ventilation volume, particularly when using a bag-valve mask.

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Assessing the feasibility of cardiopulmonary resuscitation over bulletproof vests: Implications for rapid response by police officers

Barcala‐Furelos,

Aranda‐García,

Díaz‐Sobral

et al. 2024

Hong Kong j. emerg. med.

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IntroductionThe aim was to evaluate the feasibility and quality of chest compressions (CCs) performed by police officers on a victim wearing a bulletproof vest as well as analyze the time taken to remove the vest.MethodsTen officers conducted two 5‐min cardiopulmonary resuscitation (CPR) trials. Trial 1: on a dummy wearing bulletproof vest (CPR‐VEST)/Trial 2: bare‐torso dummy (CPR‐NO).ResultsCC's quality and the timed vest removal. Results show that CC's quality was a median of 90% in CPR‐VEST and 99% in CPR‐NO (p = 0.08). There were significantly poorer results in CPR‐VEST in CC with correct recoil (CPR‐VEST: 12%, CPR‐NO: 10%, and p = 0.04) and rate (CPR‐VEST: 82%, CPR‐NO: 97%, and p = 0.01). The bulletproof vest removal time was 9.45 ± 1.33 s.ConclusionThe removal of the vest is prioritized to facilitate CPR. CC over the vest is performed with similar quality levels to standard CPR, supporting the immediate initiation of CPR in special circumstances where the vest cannot be removed.

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Protective athletic equipment slows initiation of CPR in simulated cardiac arrest

Cited by 21 publications

References 19 publications

CPR performance in the presence of audiovisual feedback or football shoulder pads

CPR performance in the presence of audiovisual feedback or football shoulder pads

Delivering Chest Compressions and Ventilations With and Without Men's Lacrosse Equipment

Assessing the feasibility of cardiopulmonary resuscitation over bulletproof vests: Implications for rapid response by police officers

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