Automatic compression improves adherence to advanced life support protocol in two-paramedic team. A randomized simulation study
1Department of Medical Rescue, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60608 Poznań, Poland
2Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 1/2 Długa Street, 61-848 Poznań, Poland
3Maria Sklodowska-Curie Bialystok Oncology Center,12 Ogrodowa Street, 15-027 Białystok, Poland
4Maria Sklodowska-Curie Medical Academy in Warsaw, Aleja Solidarności 12/4, 03-411 Warszawa, Poland
5Polish Society of Disaster Medicine, PO box 78, 05-090 Raszyn Warsaw, Poland
6Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka Street, 60-608 Poznań, Poland
DOI: 10.22514/sv.2020.16.0110 Vol.17,Issue 1,January 2021 pp.79-88
Published: 08 January 2021
Introduction: The use of protocols reduces the risk of human error and increases healthcare professionals’ adherence to guidelines. In a team of only two providers, following Advanced Life Support (ALS) protocol might be challenging. Automated Chest Compressions Devices (ACCD) may increase the quality of chest compressions. The aim of this study was to evaluate if the use of ACCD in resuscitation by a two-paramedic crew improves adherence to the ALS protocol. Materials and Methods: This study was designed as a prospective randomized high-fidelity cross-over simulation trial. Fifty-two doubleperson teams were enrolled. Each team performed two full resuscitation scenarios: one with ACCD (the experimental group-ACC) and one with manual compressions (the control group-MAN). Results: ACC achieved shorter mean durations of resuscitation loops, being less prolonged in relation to recommended durations than MAN (13 vs. 23 sec over recommended respectively, P = 0.0003). ACC also achieved mean times for supraglottic airway completion significantly faster than MAN: 224 ± 66 s vs 122 ± 35 s (P < 0.0001). In ACC, the intravenous line was obtained earlier then in MAN (162 ± 35 s vs 183 ± 45 s, P = 0.0111). Moreover, the first and second doses of adrenaline (epinephrine) were administered earlier 272± 58 s vs 232 ± 57 s (P = 0.0014) for the first and 486 ± 96 s vs 424 ± 69 s (P = 0.0007) for the second doses, respectively. Mean chest compression fraction (CCF) in MAN group was significantly lower (74 ± 4%) than in ACC group (83 ± 2%) (P < 0.0001). Conclusions: In a simulated setting, ACCD used by two-person paramedic teams yielded earlier achievement of resuscitation endpoints and improved delivery time of compressions. which may have implications for effective clinical resuscitation.
Quality of health care; Advanced cardiac life support; Cardiopulmonary resuscitation; Automated Chest Compression; High fidelity simulation training
Tomasz Kłosiewicz,Mateusz Puślecki,Łukasz Szarpak,Marek Dąbrowski,Bartłomiej Perek. Automatic compression improves adherence to advanced life support protocol in two-paramedic team. A randomized simulation study. Signa Vitae. 2021. 17(1);79-88.
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