Comparison of manual and mechanical cardiopulmonary resuscitation on the move using a manikin: a service evaluation

Aim: The aim of this study was to assess the effect that transporting a patient has on the quality of cardiopulmonary resuscitation (CPR) provided during pre-hospital resuscitation. Utilising the 2010 European Resuscitation Council (ERC) guidelines as a framework, one- and two-person manual CPR (SCPR) and mechanical CPR (MCPR) were directly compared in a simulated pre-hospital transport setting.

Methods: Ten practising paramedics each volunteered to participate in four pre-hospital CPR scenarios. The MCPR device used for this study was the LUCAS^TM2. Data were captured electronically using QCPR^TM wireless technology (Resusci Anne^® Wireless SkillReporter^TM manikin and software by Laerdal Medical^©).

Results: A reduction in the rate, depth and percentage of correct compressions was noted when the paramedics were moving the patient. In relation to the 2010 ERC guidelines, the SCPR did not meet current guidelines and was of more variable quality than MCPR. MCPR was consistent and conformed to the guidelines. However, the application of the LUCAS^TM2 when only one paramedic was present resulted in a significant delay in commencing chest compressions.

Conclusion: In the pre-hospital setting, transporting a patient during a cardiac arrest can have a deleterious effect on the quality of chest compressions being provided. When provided by a mechanical device rather than manually, the quality of chest compressions produced is closer to that currently recommended, but two persons would be required for timely deployment of the device and to maximise the chest compression fraction. This could suggest a potential use for pre-hospital MCPR even in the absence of recommendation for routine use.