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Effect of Timing of Mechanical Chest Compression Device Applied on Adrenaline Time: A Single-Center Prospective

Shingo Yamazaki1,2, Koshi Nakagawa3, Hiroki Ueta4

  • 1Emergency Medical Services Division, Yokosuka City Fire Bureau, Yokosuka, JPN.

Cureus
|September 29, 2025
PubMed

Insights

Early application of mechanical chest compression devices (MCDs) in out-of-hospital cardiac arrest (OHCA) is linked to faster adrenaline administration. This study found that early MCD use improved adrenaline timing without increasing scene time, suggesting optimized protocols are beneficial.

Area of Science:

  • Emergency Medicine
  • Cardiovascular Research
  • Resuscitation Science

Background:

  • The optimal timing for mechanical chest compression device (MCD) application relative to adrenaline administration in out-of-hospital cardiac arrest (OHCA) is not well-established.
  • Understanding this relationship is crucial for improving resuscitation outcomes.

Purpose of the Study:

  • To investigate the association between the time to MCD initiation and the time to adrenaline administration in OHCA patients.
  • To determine if earlier MCD application leads to earlier adrenaline delivery.

Main Methods:

  • A prospective cohort study analyzed emergency transport data from 174 OHCA patients who received adrenaline post-MCD application.
  • Patients were grouped into early (1-5 min) and late (≥ 6 min) MCD application cohorts.
  • Multivariable logistic regression with propensity score adjustment was used to analyze adrenaline time and scene time interval (STI).

Main Results:

  • The early MCD group exhibited a significantly shorter median adrenaline administration time (14.0 min) compared to the late MCD group (18.0 min).
  • Early MCD application was strongly associated with earlier adrenaline administration (AOR: 3.47).
  • Early MCD application did not significantly reduce the scene time interval (STI) (AOR: 1.71).

Conclusions:

  • Early application of mechanical chest compression devices in OHCA is associated with earlier adrenaline administration.
  • This early intervention does not appear to prolong the time spent at the scene.
  • Regional Medical Control Councils should develop protocols and training to enhance early MCD and adrenaline administration in OHCA resuscitation.
Abstract

Keywords:
adrenalineadvanced life supportcardiopulmonary resuscitationemergency medical servicesmechanical chest compression deviceout-of-hospital cardiac arrest

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