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clinical skills
OHCA
literature review
CPR

Mechanical chest compressions and survival in the emergency setting

02 February 2021
Features
02 February 2021
Volume 13 · Issue 2

Abstract

Advances in cardiac arrest management have led to the use of a mechanical chest compression device in an attempt to improve outcomes in cardiopulmonary resuscitation (CPR). This systematic review set out to identify whether the inclusion of the mechanical device improves survival rates in the cardiac arrest patient within the emergency setting, and explored the themes: training, environment and time of device deployment. The systematic review measured the value of mechanical chest compression devices versus standard manual compressions in respect to resuscitation outcomes (return of spontaneous circulation). Ten studies with data from 12 894 adult patients, who presented with out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA), were included. Results demonstrated an equality between manual and mechanical CPR with a statistical increase in survival when the mechanical device is used. Training, time of deployment, guideline adherence and timing of rhythm check/defibrillation presented challenges in the analysis of the data.

In cardiac arrest, the heart will cease from beating suddenly. Cardiopulmonary resuscitation (CPR) provides a manual pressing of the chest to mimic the physical contraction of the heart, thus circulating blood to the vital organs when the heart is unable to beat itself. Poole et al (2018) supports the need for high-quality chest compressions, noting them as a critical component in the chain of survival. As CPR improves survival chances, devices have been developed to support, and replace, manual chest compressions, which are commonly delivered to an inferior quality in clinical practice (Abella et al, 2005; Perkins et al, 2015; Hardig et al, 2017). The concept of the device is to ensure systematic pressing of the chest and therefore prolonged and effective compressions. This, in theory, should allow for human fatigue issues, deliver a consistent pressure and focused timing in line with changing guidelines.

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Cardiopulmonary resuscitation (CPR)
Mechanical
Survival rate
Return of spontaneous circulation (ROSC)
Cardiac arrest