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Original article
Mountain rescue cardiopulmonary resuscitation: a comparison between manual and mechanical chest compressions during manikin cardio resuscitation
  1. Oyvind Thomassen1,
  2. Sven Christjar Skaiaa2,3,
  3. Jorg Assmuss4,
  4. Øyvind Østerås1,
  5. Jon Kenneth Heltne1,5,
  6. Lars Wik6,7,
  7. Guttorm Brattebo1,8
  1. 1 Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
  2. 2 Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
  3. 3 Hemsedal Medical Office, Hemsedal, Norway
  4. 4 Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
  5. 5 Department of Clinical Medicine, University of Bergen, Bergen, Norway
  6. 6 Norwegian National Advisory Unit on Prehospital Emergency Medicine, Oslo University Hospital, Oslo, Norway
  7. 7 Department of Air Ambulance, 119 Section, Emergency Medicine Clinic, Oslo University Hospital, Oslo, Norway
  8. 8 Norwegian National Advisory Unit on Trauma, Oslo, Norway
  1. Correspondence to Dr Oyvind Thomassen, Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5097, Norway; oyvt{at}helse-bergen.no

Abstract

Aim Chest compression devices are useful during mountain rescue but may cause a delay in transport if not immediately available. The aims of this prospective observational study were to compare manual and mechanical cardiopulmonary resuscitation (CPR) during transport on a sledge connected to a snowmobile with a non-moving setting and to compare CPR quality between manual and two mechanical chest compression devices.

Methods Sixteen healthcare providers simulated four different combined CPR scenarios on a sledge in a non-moving setting and during transport and two mechanical chest compression devices during transport on the sledge. The study was conducted in May 2015 in a mountain in Norway. The primary outcome measures were compression rate (compressions per minute), compression depth in millimetres, leaning (incomplete chest wall release after compression in millimetres) and chest compression fraction (fraction of total time were compression were performed). The results were analysed by descriptive and graphical methods and paired t-tests were used to compare the differences between techniques.

Results We did not observe a significant difference between moving and non-moving conditions with respect to manual compression rate (p=0.34), compression depth (p=0.50) or leaning (p=0.92). However, both the manual compression depth (p<0.001) and the leaning (p=0.04) showed a significantly larger variance during the moving runs.

Conclusion Manual chest compression is possible on a snowmobile during transport even in challenging terrain. This experimental study shows that high-quality chest compressions and manual ventilation can be performed in an intubated patient during a short-term transportation on a sledge.

  • cardiac arrest
  • critical care transport
  • hypothermia
  • prehospital care
  • resuscitation
  • research

https://doi.org/10.1136/emermed-2016-206323

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    Footnotes

    • Contributors All authors have contributed to the design of the study, writing the manuscript and the revision process. OT, SCC, JA, OO, GB and JKH performed the field study.

    • Competing interests LW is a NAKOS representative in the Medical Advisory Board for PhysioControl and a principle investigator for studies with the Load Distributing Band (AutoPulse) and Lund University Cardiac Assist System (LUCAS2) mechanical chest compression devices. The other authors have no conflict of interest to declare. The AutoPulse and LUCAS2 were borrowed from the manufacturers, but the study did not receive financial or other sorts of support from any manufacturer.

    • Ethics approval The study was approved by the Data Protection Officials for Research (2015/5342). The Regional Committee for Medical Research Ethics assessed the study and decided that no approval was needed.

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