Quality Comparison of the Manual Chest Compression and the Mechanical Chest Compression During Difficult Transport Conditions

Abstract

Background: Although there are several studies comparing the quality of manual and mechanical chest compressions, we decided to conduct this study because results of previous studies were not sufficient for us to arrive at a definite conclusion.

Objective: In this study, our goal was to evaluate the quality of cardiopulmonary resuscitation (CPR) performed manually and by mechanical chest compression device (MCCD) when removing out-of-hospital cardiac arrest patients from their homes via stairs.

Methods: A total of 20 paramedics participated in the study. The patient simulator manikin was moved down the stairs while each of 20 paramedics performed chest compressions, then it was moved down the stairs again 20 times while the MCCD performed chest compressions. Compression depth, compression rate, and hands-on times were recorded and the data were compared.

Results: The median chest compression rate was 142.0 compressions/min (interquartile [25^th to 75^th percentile] range [IQR] 134.9-148.7 compressions/min) for the paramedics and 102.3 compressions/min for the MCCD (IQR 102.2-102.5 compressions/min) (p < 0.01). The median chest compression depth was 25.2 mm (IQR 23.2-30.9 mm) for the paramedics and 52.0 mm for the MCCD (IQR 51.4-52.6 mm) (p < 0.001). The rate of hands-on time for chest compressions performed by the paramedic participants was 92.0% (IQR 86.5-100%). Hands-on rate of the MCCD was 100% (p = 0.09).

Conclusions: In our study, while carrying the patient simulator manikin to the lower floor, it was found that the MCCD achieved high-quality CPR targets recommended by resuscitation guidelines in terms of compression rate, depth, and hands-on-time.

Keywords: CPR quality; chest compression; mechanical devices; prehospital; resuscitation.