Effect of mattress deflection on CPR quality assessment for older children and adolescents
Nishisaki, Akira, Nysaether, Jon, Sutton, Robert, Maltese, Matthew, Niles, Dana, Donoghue, Aaron, Bishnoi, Ram, Helfaer, Mark A., Perkins, Gavin D., Berg, Robert A., Arbogast, Kristy B. and Nadkarni, Vinay M.. (2009) Effect of mattress deflection on CPR quality assessment for older children and adolescents. Resuscitation, Vol.80 (No.5). pp. 540-545. ISSN 0300-9572
WRAP_Perkins_1070268-lb-190511-perkins_mattress18dec2008_final1_(1).pdf - Accepted Version - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Official URL: http://dx.doi.org/10.1016/j.resuscitation.2009.02....
Appropriate chest compression (CC) depth is associated with improved CPR outcome. CCs provided in hospital are often conducted on a compliant mattress. The objective was to quantify the effect of mattress compression on the assessment of CPR quality in children.
Methods: A force and deflection sensor (FDS) was used during CPR in the Pediatric Intensive Care Unit and Emergency Department of a children's hospital. The sensor was interposed between the chest of the patient and hands of the rescuer and measured CC depth. Following CPR event, each event was reconstructed with a manikin and an identical mattress/backboard/patient configuration. CCs were performed using FDS on the sternum and a reference accelerometer attached to the spine of the manikin, providing a means to Calculate the mattress deflection.
Results: Twelve CPR events with 14,487 CC (11 patients, median age 14.9 years) were recorded and reconstructed: 9 on ICU beds (9296 CC), 3 on stretchers (5191 CC). Measured mean CC depth during CPR was 47 +/- 8 mm on ICU beds, and 45 +/- 7 mm on stretcher beds with overestimation of 13 +/- 4 mm and 4 +/- 1 mm, respectively, due to mattress compression. After adjusting for this, the proportion of CC that met the CPR guidelines decreased from 88.4 to 31.8% on ICU beds (p < 0.001), and 86.3 to 64.7% on stretcher (p < 0.001 The proportion of appropriate depth CC was significantly smaller on ICU beds (p < 0.001).
Conclusion: CC conducted on a non-rigid surface may not be deep enough. FDS may overestimate CC depth by 28% on ICU beds, and 10% on stretcher beds.
|Item Type:||Journal Article|
|Subjects:||R Medicine > RC Internal medicine|
|Divisions:||Faculty of Medicine > Warwick Medical School|
|Library of Congress Subject Headings (LCSH):||Cardiac resuscitation, Mattresses|
|Journal or Publication Title:||Resuscitation|
|Publisher:||Elsevier Ireland Ltd|
|Official Date:||May 2009|
|Number of Pages:||6|
|Page Range:||pp. 540-545|
|Access rights to Published version:||Open Access|
|Funder:||Laerdal Medical Corporation, Children's Hospital of Philadelphia|
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