Transport with ongoing resuscitation: a comparison between manual and mechanical compression

Gäßler, Holger; Ventzke, Marc-Michael; Lampl, L.; Helm, Matthias

doi:10.1136/emermed-2012-201142

Cited by 46 publications

(41 citation statements)

References 21 publications

(20 reference statements)

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“…For all Poor manual CPR-quality while moving patients is in accordance with prior publications that studied CPRquality during other phases of the overall patient transport, e.g. in an ambulance or a helicopter [9][10][11]. While human and manikin studies focused on "technical" parameters of CPR-quality, such as compression depth and frequency and hands-off-time, a recent trial in a porcine model analysed haemodynamic parameters during manual or mechanical CPR in a moving ambulance.…”

Section: Discussionsupporting

confidence: 76%

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

Drinhaus

Nüsgen²,

Adams

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: If transport under ongoing cardiopulmonary resuscitation (CPR) from an upper floor is indicated, the ideal CPR-method and evacuation route is unknown hitherto. We aimed to elaborate a strategy for evacuation of patients under ongoing CPR from an upper floor, comparing three different evacuation routes and manual and mechanical chest compressions. Methods: A CPR-training manikin recording CPR-quality was placed on the fifth floor and was evacuated to an ambulance via lift, turntable ladder, or staircase. Chest compressions were performed manually or with a mechanical CPR-device. Efficiency endpoints were compression depth and frequency, sufficiency of chest release, compared with European Resuscitation Council (ERC) Guidelines, and duration of the evacuation. Adverse outcomes were disconnection/dislocation of devices and hazards/accidents to the personnel.Results: For all evacuation routes, compression depth and frequency were significantly more compliant with ERCguidelines under mechanical CPR. Manual CPR was associated with considerable deviations from correct compression depth and frequency. Chest release only slightly differed between groups. Evacuation via lift under mechanical CPR was fastest and evacuation via turntable ladder under manual CPR was slowest. No device disconnections or accidents occurred, but hazard to personnel was perceived during evacuation via ladder under manual CPR. Conclusions:In this study, a mechanical CPR-device proved to deliver better CPR-quality during evacuation from an upper floor. If a lift accessible with a stretcher is available, this route should be preferred, regardless of manual or mechanical CPR. Turntable ladders can only be meaningfully used with mechanical CPR, otherwise CPR-quality is poor and hazard to the personnel is increased. Not all evacuation routes may be useable in a specific real-life scenario.

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Section: Discussionsupporting

confidence: 76%

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

Drinhaus

Nüsgen²,

Adams

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…Hence, we used the LUCAS automated chest compression device. This decision is further supported by the fact that the LUCAS is superior to manual compressions during helicopter28 and ambulance29 transport as well. Even though the LUCAS does not appear to enhance the survival rate and neurological outcome compared with manual CPR in an overall analysis,30 it has to be stated that there are certain scenarios—like in-water resuscitation or helicopter transport—in which manual CPR is impossible.…”

Section: Discussionmentioning

confidence: 96%

Helicopter-based in-water resuscitation with chest compressions: a pilot study

et al. 2014

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CPR appears to be possible when performed in a rescue platform with special equipment. The novel helicopter-based strategy appears to enable the rescuers to initiate CPR in an appropriate length of time and with an acceptable amount of physical exertion for the divers. The time for the helicopter to reach the patient will have to be very short to minimise neurological damage in the drowning victim.

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“…Sunde et al examined compression quality at the site of the incident, when walking on a horizontal plane and on stairs [22]. On the basis of these data and on the study of Gaessler et al, observing lower quality in manual chest compression during ambulance and braking manoeuvres, the use of mCPR devices represents a possibility for effective chest compression with protracted resuscitation [23].…”

Section: Discussionmentioning

confidence: 99%

Testing mechanical chest compression devices for pre-hospital patient transport under resuscitation

Jörgens

Körniger²,

Kanz

et al. 2020

Preprint

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Background Mechanical chest compression (mCPR) offers advantages during transport under cardiopulmonary resuscitation. Little is known how devices perform en-route. Aim of the study was to measure performance of mCPR devices of different design during 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 and compression-ventilation ratio was 40% (AM), 87% (CC, L2 respectively) and 93% (AP). 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), 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.

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Transport with ongoing resuscitation: a comparison between manual and mechanical compression

Cited by 46 publications

References 21 publications

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

Helicopter-based in-water resuscitation with chest compressions: a pilot study

Testing mechanical chest compression devices for pre-hospital patient transport under resuscitation

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