Comparison of Cardiopulmonary Resuscitation Quality in a Simulated Model: At Incident Scene vs During EMS Transport

Area of Science:

• Emergency Medicine
• Cardiology
• Resuscitation Science

Background:

• Out-of-hospital cardiac arrest (OHCA) is a critical medical emergency with high mortality rates.
• International guidelines stress the importance of high-quality cardiopulmonary resuscitation (CPR) for improving OHCA survival.
• Effective CPR delivery is crucial for patient outcomes during emergency medical services (EMS) interventions.

Purpose of the Study:

• To compare the quality of CPR delivered at an incident scene versus during ambulance transport.
• To evaluate CPR efficiency based on international guidelines in two distinct out-of-hospital cardiac arrest scenarios.
• To identify potential differences in CPR metrics between static and mobile resuscitation environments.

Main Methods:

• CPR quality was assessed on a manikin in two simulated scenarios: on-scene and during transport.
• Five 2-minute cycles of chest compressions were performed per scenario by healthcare professionals.
• Key quality parameters included chest compression rate, depth, and hand placement accuracy.

Main Results:

• CPR during transport showed a significantly higher compression rate (125.3/min vs 120.5/min) and shallower compression depth (37.9 mm vs 43.9 mm) compared to on-scene.
• The rate of correct hand placement was statistically similar between the two scenarios (92.2% vs 92.1%).
• Data were analyzed from 240 CPR cycles involving 24 healthcare professionals.

Conclusions:

• CPR delivered during simulated ambulance transport exceeded recommended compression rates and achieved shallower depths.
• While hand placement accuracy remained consistent, deviations in rate and depth may impact CPR effectiveness.
• EMS providers must recognize and mitigate potential reductions in CPR quality when patients require transport during resuscitation efforts.