Abstract P136: Mechanical Chest Compressions Improve Short-term Outcome in Patients Requiring CPR During Transport
Introduction: Chest compression (CC) quality is compromised during patient transport due to the difficulty of performing CC in a moving ambulance. Mechanical CC devices can be utilized to improve CC quality during transport; however, it is presently unclear whether cardiac arrest patient outcome is improved with use of mechanical CC devices during transport. We tested the hypothesis that use of a mechanical CC device would lead to improved resuscitation success for cardiac arrest patients during transport.
Methods: The records of 617 consecutive non-traumatic cardiac arrest patients treated and transported by Charleston County EMS between January 2004 and January 2007 were reviewed to identify patients that were transported with ongoing CPR. A total of 509 patients met the criteria of not achieving return of spontaneous circulation (ROSC) at the scene and of being transported with ongoing CPR. During the study period, the agency gradually equipped its ambulances mechanical chest compression devices (AutoPulse, ZOLL Medical); thus, 50% of patients were treated with LDB-CC and 50% were treated with manual CC.
Results: Overall, 55 (11%) patients achieved ROSC for the first time during transport. Patients treated with the mechanical CC were more likely to achieve ROSC during transport compared with patient treated with manual CC (14.3% vs. 6.7%, p=0.005). Duration of EMS treatment at the scene was shorter for patients that achieved ROSC during transport vs. those that did not (20.7±6.1 min ROSC vs. 23.0±7.9 min no ROSC, p=0.03). There were no differences in age, gender, witnessed arrest, EMS witnessed arrest, location of arrest, bystander CPR, initial rhythm, or response time (all p≥0.2). Of the 55 patients that achieved ROSC during transport, 44 (80%) qualified for transport according to ALS termination of resuscitation protocols.
Conclusions: Patients treated with mechanical CC during transport are more likely to be resuscitated during transport compared with patients receiving manual CC presumably due to improved CC quality during transport.