Since 2008, our ambulance service has used a mechanical compression device as standard equipment in the prehospital treatment of OHCA. Mechanical compression devices purportedly improve the quality of chest compressions by minimizing interruptions and maintaining optimal rate and depth. In late 2012, we acquired the necessary tools and training to institute a cardiac arrest post-event TTI review process in our ambulance service. With the use of specialized software, TTI tracings can be used to examine the rate of chest compressions and the frequency and duration of compression pauses that occurred during a resuscitation attempt. According to the most recent CPR guidelines from the American Heart Association (AHA), an essential component of high quality CPR is the delivery of chest compressions at the proper rate and depth with minimal interruption, and transthoracic impedance (TTI) data captured by electrocardiogram (EKG) defibrillator/monitors can be used to retrospectively assess certain aspects of chest compression quality. In 2013, only 9.5% of OHCA victims survived to hospital discharge, and it is well known that a key determinant of survival is the rapid delivery of high quality cardiopulmonary resuscitation (CPR). Based on these findings, our system will emphasize earlier device placement with minimal pauses for application.Ĭardiography, Impedance, Cardiopulmonary Resuscitation/Methods, Emergency medical services/Methods, Out-of-Hospital cardiac arrest/Therapy, Cardiopulmonary Resuscitation/Instrumentation,Īn estimated 350,000 people suffer out-of-hospital cardiac arrests (OHCA) annually in the United States. On average, device placement occurred approximately 4 minutes after the start of TTI recording, with a median application pause of 26 sec (IQR = 17-44).Ĭonclusion: These data demonstrate that use of a mechanical chest compression device can improve compression fraction and increase compliance with compression rate guidelines, but further study is needed to determine whether the observed improvement in compression quality after device placement is solely related to the mode of compression. Median compression rates were 121/min during manual compressions and 102/min with the mechanical device (p < 0.001). Median compression fraction was lower during manual versus mechanical compressions (77% vs. The median (range) duration of the manual and mechanical phases were 3:13 min (0:05-19:51) and 23:24 min (0:13-65:30), respectively. Results: A total of 202 events met inclusion criteria. Time of first mechanical compression and duration of main pause for compression device application were also determined. The main pause for LUCAS™ application was not included in either phase. Two paramedics independently annotated and reviewed TTI tracings using CodeStat™ software, isolated the manual and mechanical compression phases of the arrest, and recorded total CPR time, compression rate (per min) and compression fraction for each distinct phase. Events were excluded from analysis if the TTI recording was unavailable or of inadequate quality, or if duration of recorded compressions was < 5 minutes. Methods: A retrospective analysis was conducted among all LUCAS™-aided OHCA worked by a single ambulance service in Minnesota in 2013. In this study, we use TTI data to compare chest compression quality metrics from the manual versus mechanical compression phases of out-of-hospital cardiac arrests (OHCA) treated with the LUCAS™ mechanical compression device. Objective: Mechanical compression devices purportedly improve the quality of chest compressions by minimizing interruptions and maintaining optimal rate and depth, but this claim has not been objectively substantiated using transthoracic impedance (TTI) recordings from applied setting cardiac arrests. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. (2016) Use of Transthoracic Impedance Data to Evaluate Intra-arrest Chest Compression Quality. Lori L Boland, Managing Scientist, Division of Applied Research, Allina Health, 2925 Chicago Avenue, Minneapolis, MN 55407, USA, Tel: 61, Email: Int J Crit Care Emerg Med, IJCCEM-2-014, (Volume 2, Issue 1), Research Article ISSN: 2474-3674 Received: Febru| Accepted: Ap| Published: May 02, 2016Ĭitation: Kamrud JW, Boland LL, Frazee CL, Kinzy TG, Satterlee PA, et al.
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