Compression feedback devices over estimate chest compression depth when performed on a bed

• Published in: Resuscitation Vol. 80; no. 1; pp. 79 - 82
• Main Authors: Perkins, Gavin D, Kocierz, Laura, Smith, Samuel C.L, McCulloch, Robert A, Davies, Robin P
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.01.2009; Elsevier
• Subjects: Advanced life support; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Backboard; Basic life support; Beds; Biological and medical sciences; Cardiopulmonary Resuscitation - instrumentation; Cardiopulmonary Resuscitation - methods; Chest compression; Compressive Strength; Emergency; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Equipment Design; Equipment Failure; Equipment Failure Analysis; Feedback; Humans; Intensive care medicine; Manikins; Medical sciences; Thorax; Chest compression; Backboard; Basic life support; Advanced life support; Feedback; Intensive care; Resuscitation
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2008.08.011

Summary Introduction CPR feedback/prompt devices are being used increasingly to guide CPR performance in clinical practice. A potential limitation of these devices is that they may fail to measure the amount of mattress compression when CPR is performed on a bed. The aim of this study is to quantify the amount of mattress compression compared to chest compression using a commercially available compression sensor (Q-CPR, Laerdal, UK). A secondary aim was to evaluate if placing a backboard beneath the victim would alter the degree of mattress compression. Methods CPR was performed on a manikin on the floor and on a bed with a foam or inflatable mattress with and without a backboard. Chest and mattress compression depths were measured by an accelerometer placed on the manikin's chest (total compression depth) and sternal–spinal (chest) compression by manikin sensors. Results Feedback provided by the accelerometer device led to significant under compression of the chest when CPR was performed on a bed with a foam 26.2 (2.2) mm or inflatable mattress 32.2 (1.16) mm. The use of a narrow backboard increased chest compression depth by 1.9 mm (95% CI 0.1–3.7 mm; P = 0.03) and wide backboard by 2.6 mm (95% CI 0.9–4.5 mm; P = 0.013). Under compression occurred as the device failed to compensate for compression of the underlying mattress, which represented 35–40% of total compression depth. Conclusion The use of CPR feedback devices that do not correct for compression of an underlying mattress may lead to significant under compression of the chest during CPR.