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Chest compression fraction in ambulance while transporting patients with out-of-hospital cardiac arrest to the hospital in rural Taiwan
  1. Shih-Chang Hung1,2,
  2. Ching-Yi Mou1,3,
  3. Hung-Chang Hung2,4,
  4. I-Hsiang Lin4,
  5. Shih-Wei Lai5,6,
  6. Jack YinChun Huang7
  1. 1Department of Emergency Medicine, Nantou Hospital, Nantou, Taiwan
  2. 2Department of Health Care Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
  3. 3National Environmental Health Research Center, National Health Research Institutes, Miaoli, Taiwan
  4. 4Department of Internal Medicine, Nantou Hospital, Nantou, Taiwan
  5. 5College of Medicine, China Medical University, Taichung, Taiwan
  6. 6Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
  7. 7Fire Department of Nantou County, Second Corps, Puli Branch, Nantou, Taiwan
  1. Correspondence to Shih-Wei Lai, Department of Family Medicine, China Medical University Hospital, 2, Yu-De Road, Taichung City, 404, Taiwan; wei{at}mail.cmuh.org.tw

Abstract

Introduction Maintaining the standard two-handed chest compression is difficult in high-speed ambulances in rural areas.

Methods A retrospective, video-based, observational study was conducted from June to September 2013 in Nantou, a rural county of central Taiwan, to evaluate the chest compression fraction in an ambulance carriage during the travel from the scene to the hospital. The chest compression fraction was calculated as the chest compression time period divided by the ambulance travelling time period; the one-handed and two-handed chest compression fractions were also calculated.

Results During the 4-month study period, a total of 102 videos that were recorded in an ambulance carriage were reviewed, including 97 cases of manual chest compressions. When there was only one emergency medical technician (EMT) in the carriage, the combined chest compression fraction was 50.6±20.7%; when there were two EMTs, the fraction was 58.3±16.0% and the fraction was 58.3±21.0% in a three-EMT scenario (p=0.221). Moreover, in the carriage, EMTs usually performed one-handed chest compressions.

Conclusions The chest compression fraction was low for patients with out-of-hospital cardiac arrest in a moving ambulance, irrespective of the number of providers. Reasons for this observation, as well as the effectiveness of the one-handed chest compression require further evaluation.

  • pre-hospital
  • chain of survival
  • emergency ambulance systems

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Footnotes

  • Contributors S-CH substantially contributed to the conception of this article. He initiated the draft of the article and critically revised the article. H-CH substantially contributed to the conception of this article. Y-HL and C-YM contributed to data collection, analysis and interpretation. S-WL conducted the data analysis and critically revised the article. All authors approved the final version to be published.

  • Funding This study was partly supported by the Project of Incentive to Research for Ministry of Health and Welfare Hospitals (10229).

  • Competing interests None declared.

  • Ethics approval This study was approved by the ethics review board of the Taoyuan General Hospital in Taiwan (TYGH101030).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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