Study On CPR During Ambulance Transport Of Cardiac Arrest Patients Named "Best EMS Professional Research Presentation" At NAEMSP Conference
This study was conducted with Guardian Medical Transport in Flagstaff, Arizona, and the Mesa Fire Department in Mesa, Arizona, as part of a larger Resuscitation Quality Improvement Program. The aim was to quantify and compare the quality of chest compressions at the scene of a resuscitation attempt and during transport. The research was undertaken in response to questions that had been raised about the safety and efficacy of performing manual chest compressions during the ambulance transport of patients in cardiac arrest.
Dr. Bobrow stated, "We found an increase in the variability of chest compression quality for the rate and depth of compressions in our two EMS agencies during the ground transport of cardiac arrest patients. Further investigation is needed to determine the causes of the increased variability along with the optimal timing and method of delivering manual chest compressions."
The EMS agencies participating in the project utilized ZOLL E Series monitor-defibrillators with an accelerometer to continuously record chest compression quality during resuscitation both at the scene and during ambulance transport. The device's built-in Real CPR Help®, which provides real-time audiovisual feedback on the correct rate and depth of chest compressions, was inactivated. ZOLL's Code Review software was used to collect data on chest compression quality during the time a patient was treated at the scene and in transport. The time during which the patient had spontaneous circulation was excluded from analysis as CPR would not have been required during those minutes. Variability was defined as the average of minute-by-minute standard deviations in depth or rate.
A total of 90 adult cardiac arrest events were electronically recorded, of which 45 included chest compressions both at the scene and in the ambulance. Variability in chest compression rate and chest compression depth was significantly greater during transport compared with at the scene. Absolute chest compression depth and chest compression rate tended to be lower during transport. Although not reaching statistical significance, the percentage of chest compressions in compliance with AHA 2005 guidelines for depth (1.5-2 in) and rate (100±10 compressions/minute) was nearly double at the scene compared with during transport.
"We are pleased that ZOLL technology was used in this study," said Jonathan A. Rennert, President of ZOLL. "We are very committed to helping agencies conduct research that may ultimately result in improving outcomes from cardiac arrest."
About Sudden Cardiac Arrest
SCA, an abrupt disruption of the heart's function, which causes a lack of blood flow to vital organs, claims more than 1 million lives each year. It is the leading cause of unexpected death in the world and strikes without warning. Currently, only about 5 percent of victims survive; 95 percent will die from SCA.
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