Abstract 343: Chest Compression Compliance With Guidelines Declines Over the Course of Rescues

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
James K Russell ◽  
Digna González Otero ◽  
Sofia Ruiz de Gauna ◽  
Mikel Leturiondo ◽  
Jesus M Ruiz ◽  
...  
Keyword(s):  
Real Time ◽  
Chest Compression ◽  
Steady Increase ◽  
Release Force

Introduction: CPR guidelines recommend limits for rate and depth, and release (avoidance of leaning). Simultaneous compliance with all three recommendations is challenging, sustained compliance more so. Hypothesis: Compliance with rate, depth and release guidelines is limited, and will decline over the course of rescues. Methods: Acceleration and force signals were extracted from monitor/defibrillators equipped with CPR monitors in 248 adult cases of manual CPR during out-of-hospital resuscitations treated by Tualatin Valley Fire & Rescue (TVF&R, Tigard, OR) during 2016 and 2017. TVF&R personnel delivered continuous compression CPR with real-time feedback available for rate, depth and leaning. Depth was calculated from acceleration. Peak depth, release force, and rate were measured for each compression. Release with force exceeding 2.5 kg-f was counted as incomplete (leaning). Results: Cases included 1802 (1055-2683) (median, IQR) compressions (total 481,407 compressions). Compliance with all three recommendations was 25% initially, declining to 19% for the ends of the longest rescues (> 3000 compressions from 48 cases). Depth compliance and complete release varied relatively little (31-36%, 93-95% respectively) and irregularly over the course of resuscitation. Early, 45% of compressions were too shallow (< 50 mm), and 21% were too deep (> 60 mm). Depth exceptions shifted over the course of resuscitation (to 36%, 28% respectively). Rate compliance declined from 73% to 54%. Rates below 100 cpm were 9% initially, declining to 5%. Rates exceeding 120 cpm were 18% early on, but climbed to 41% towards the end of long resuscitations, accounting for most of the decline in compliance with guidelines. Conclusions: Compliance with all 3 recommendations for CPR compressions is challenging, and becomes more so as the chest changes in response to compressions. Most problematic is a steady increase in compression rates above 120 cpm.

Abstract 2019: Untrained Volunteers Perform High Quality CPR When using an Automatic External Defibrillator with a CPR Voice Prompting Algorithm

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Benjamin S Abella ◽  
Salem Kim ◽  
Alexandra Colombus ◽  
Cheryl L Shea ◽  
Lance B Becker
Keyword(s):  
Real Time ◽  
Patient Outcomes ◽  
Chest Compression ◽  
Automatic External Defibrillator ◽  
Chest Compressions ◽  
High Quality ◽  
Cpr Training ◽  
Adult Volunteers ◽  
Improve Patient ◽  
External Defibrillator

Background: Recent investigations have demonstrated that CPR performance among trained providers can be improved by audiovisual prompting and real-time feedback, and higher quality CPR before defibrillation can improve shock success and has the potential to improve patient outcomes. Objective: We hypothesized that simplified voice prompts incorporated into an automatic external defibrillator (AED) can lead to improvements in CPR performance by untrained lay rescuers. Methods: Adult volunteers with no prior CPR training were assessed in their use of an AED with chest compression voice instructions and metronome prompts on a CPR-recording manikin. Volunteers were given minimal instructions regarding use of the device and were given no instructions regarding CPR performance. The AED was designed to prompt five cycles of 30 chest compressions between defibrillatory attempts. Chest compression rates and depths were measured via review of videotape and manikin recording data, respectively. Results: A total of 60 adults were assessed in their use of the AED, with a mean age of 33.6±12.8; 36/63 (57%) were female. Mean chest compression rate was 103±12 and mean depth was 37±14 mm. Furthermore, minimal decay in chest compression rates occurred over 5 cycles of chest compressions, with mean rate of 101±19 during the first cycle and 104±10 during the 5 th cycle. No volunteers were unable to use the AED or complete 5 cycles of chest compressions. Conclusions: Our work demonstrates that with appropriate real-time prompts delivered even in the absence of training or human coaching, laypersons can perform CPR that has a quality often similar to trained providers. This finding has important implications for AED design especially in light of the renewed importance of both CPR and the interaction of quality chest compressions and defibrillatory success.

The impact of real-time chest compression feedback increases with application of the 2015 guidelines

2019 ◽  
Vol 54 ◽  
pp. 145-150
Author(s):  
Daniel Davis ◽  
Tifany Hoyne ◽  
Sara Wattenbarger ◽  
Kenan Kuntsal ◽  
Annemarie Silver
Keyword(s):  
Real Time ◽  
Chest Compression ◽  
The Impact

Abstract 456: Increasing the Compression Velocity and Acceleration Improved the Quality of Simulated Chest Compression Under the Direction of Real Time Visual Feedback Device

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Yu Cao ◽  
Yarong He ◽  
Peng Yao
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Linear Regression ◽  
Real Time ◽  
Visual Feedback ◽  
Chest Compression ◽  
Independent Risk Factor ◽  
Baseline Test ◽  
Independent Risk Factors

Background: To investigate whether a real-time visual feedback device could improve the quality of chest compression (CC), and, if so, whether the mechanism is associated with dynamic indexes such as velocity and acceleration. Methods: A self-control trial of 2-minutes CC on a manikin by trained rescuers compared the quality of CC without or with a visual feedback device. Demographic characteristics were recorded and CC metrics for the two tests were computed. Multivariable linear regression analyses were performed to examine the impact of variables on rate of qualified chest compression (RQCC). Multivariable logistic regression was performed to determine independent risk factors for achieving qualified chest compression (QCC) in the second test. Results: A total of 159 participants (average age: 29.36±9.0 years, 80 (50.3%) men) were recruited. RQCC of the second test was significantly greater than that of the baseline test. Multivariable linear regression analysis showed that maximum compression velocity (V compression ) and maximum compression velocity (a compression ) were independent risk factors for RQCC for both tests. The mean V compression and a compression of the second test were significantly greater than those of the baseline test. However, V compression was the only independent risk factor predicting QCC achievement during the second test. ROC curve analysis showed the area under curve (AUC) was0.84,and the optimal cut-offvalue ofV compression was 39.48 cm/s. Conclusions: Increasing the V compression and a compression might improve the quality of simulated CC and should be recommended to improve QCC. Only V compression was an independent risk factor for achieving QCC during CC with a visual feedback device.

Abstract 482: Differences in Ground Reaction Forces and Chest Compression Release Velocity in Professional and Lay Rescuers With and Without the Use of Real-Time CPR Feedback

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Lyra Clark ◽  
Ben Senderling ◽  
Jeff R Gould ◽  
Chris Kaufman ◽  
Nick Stergiou
Keyword(s):  
Real Time ◽  
Chest Compression ◽  
Reaction Force ◽  
Force Plate ◽  
Compression Cycle ◽  
Reaction Forces ◽  
Force Range ◽  
Favorable Neurological Outcome ◽  
Compression Characteristics ◽  
Pearson Correlations

Purpose: Chest compression release velocity (CCRV) has been associated with survival and favorable neurological outcome after cardiac resuscitation. Both complete chest release and high CCRV contribute to improved venous return during CPR. Differences in compression forces delivered by professional and lay rescuers are reported, which may contribute to differences in CCRV. The aim of this pilot study was to investigate differences in ground reaction force (GRF) and CCRV between professional and lay rescuers during CPR performed on a manikin with and without real-time feedback. Methods: Professional (n = 5) and lay rescuers (n = 11) performed two minutes of continuous compressions on a manikin positioned over a force plate for two trials. CPR feedback provided by a defibrillator was disabled in the first trial and enabled in the second. CPR pads containing an accelerometer were used to calculate individual compression characteristics. Relative maximum and minimum GRFs were calculated for each compression cycle and averaged over each trial. Paired and independent sample t tests and Pearson correlations were conducted in STATA 15.1. Results: CCRV was higher in professionals vs. lay rescuers with feedback disabled and enabled ( p <0.05). Professionals had greater maximal and lower minimum forces than lay rescuers without feedback ( p <0.05), though there were no differences between groups with feedback enabled (Table 1). CCRV was associated with minimum force (r = -0.63, p <0.01) and force range (r = 0.78, p <0.01) in all rescuers. Analysis of GRFs by CCRV for all rescuers indicated lower force minimum (9.71 + 3.16 N, p <0.05) with CCRV >400 mm/s in comparison to CCRV 300-400 mm/s (39.73 + 8.91 N) and CCRV 200-300 mm/s (63.82 + 16.98 N). Conclusions: CPR feedback attenuated differences in GRF between professional and lay rescuers. CCRV was greater in professionals and was associated with measures of GRF, and thus may serve as an indicator of both velocity and amount of chest release.

scholarly journals Real-time feedback improves chest compression quality in out-of-hospital cardiac arrest: A prospective cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. e0229431 ◽  
Author(s):  
Felix Lakomek ◽  
Roman-Patrik Lukas ◽  
Peter Brinkrolf ◽  
Andreas Mennewisch ◽  
Nicole Steinsiek ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Real Time ◽  
Prospective Cohort Study ◽  
Chest Compression ◽  
Prospective Cohort ◽  
Hospital Cardiac Arrest

Quality of closed chest compression on a manikin in ambulance vehicles and flying helicopters with a real time automated feedback

Resuscitation ◽  
2010 ◽  
Vol 81 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Christof Havel ◽  
Wolfgang Schreiber ◽  
Helmut Trimmel ◽  
Reinhard Malzer ◽  
Moritz Haugk ◽  
...  
Keyword(s):  
Real Time ◽  
Chest Compression ◽  
Closed Chest ◽  
Automated Feedback
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