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A stabilization device to improve the quality of cardiopulmonary resuscitation during ambulance transportation: A randomized crossover trial
Authors:Ning-Ping Foo  Jer-Hao Chang  Shih-Bin Su  Hung-Jung Lin  Kow-Tong Chen  Ching-Fa Cheng  Tsung-Yi Lin  Pei-Chung Chen  How-Ran Guo
Institution:1. Department of Emergency Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan;2. Department of Emergency Medicine, Tainan Municipal An-Nan Hospital, China Medical University, Taiwan;3. Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan;4. Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan;5. Department of Family Medicine, Chi-Mei Medical Center, Tainan, Taiwan;6. Department of Biotechnology, Southern Taiwan University, Tainan, Taiwan;g Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan;h Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan;i Tainan City Fire Burea, Tainan, Taiwan;j Department of Mechanical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan;k Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
Abstract:

Background

The quality of cardiopulmonary resuscitation (CPR) during ambulance transportation is suboptimal, and therefore measures that can improve the quality are desirable.

Purpose

To evaluate whether the use of a stabilization device can improve the quality of CPR during ambulance transportation.

Methods

This randomized controlled crossover trial enrolled 22 experienced ambulance officers. Each participant performed CPR in an ambulance under three conditions with 72 h apart, each condition for 10 min: non-moving (NM), moving without device (MND), and moving with device (MD). The sequences of conditions were randomized. The primary outcomes were effective chest compressions recorded by the Laerdal Resusci-Anne Skill-reporter manikin. The secondary outcomes included the severity of back pain scored using the Brief Pain Inventory short-form, the physiology parameter before and after CPR, and the changes in postural stability which was represented by the sway index (SI) of lower back measured using a goniometer.

Results

The overall effective compressions in 10 min were 87.0 ± 17% for NM, 59.0 ± 19% for MND, and 69.0 ± 23% for MD (p < 0.001). Compared to MND, MD had a lower no-flow fraction while driving on curved sections (0.04 vs. 0.29, p < 0.001). Whereas the pain severity and social interference scores were similar under all conditions, MND had a higher SI than MD and NM.

Conclusions

The use of a stabilization device can improve the quality of CPR and posture stability during ambulance transportation, although the effects on the severity of back pain were not significant.
Keywords:Cardiopulmonary resuscitation  Ambulance  Transportation  Back pain  Goniometer  Sway index
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