EFFECTIVENESS OF CHEST COMPRESSION IN A MOVING AMBULANCE

Linton, John A.; Lim, Kyoung Soo; Hwang, Sung Oh

J Korean Soc Emerg Med > Volume 6(2); 1995 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1995;6(2): 304-310.

EFFECTIVENESS OF CHEST COMPRESSION IN A MOVING AMBULANCE

John A. Linton¹, Kyoung Soo Lim², Sung Oh Hwang²

¹Department of Family Medicine of Yonsei University Medical College
²Department of Emergency Medicine of Wonju College of Medicine

Published online: December 31, 1995.

ABSTRACT

Chest compressions performed in a controlled environment can generate adequate coronary perfusion pressure, but compression is frequently inadequate even when CPR is performed under optimal circumstances. In Korea the average highway of road is narrow and curved more than in other countries, and the back-space in ambulance of Korea is limited to perform CPR. As a result, the CPR in a moving ambulance is not effective in Korea. We studied the effectiveness of chest compression in a moving ambulance by the use of a CPR manikin(Skillmeter Resusci Annie, Laerdal company). The ambulance was driven without a warning siren with obeying all the traffic signals and rules. Eight emergency physicians performed a total of 8 sessions of 2 minutes of continuous chest compression on the manikin in the ambulance(Van-type). They did the same thing in truck-type ambulance. We compared the results between small ambulance(Van type) and large ambulance(Truck type). To compare the effectiveness of manual and mechanical cardiac massage, the mechanical cardiac resuscitator(Thumper: Michigan company) was used. The success rate of manual CPR in a constant speed was not different between the Van-type ambulance and Truck-type ambulance(p>0.05), but mean percentage of correct compression by mechanical chest compressor showed 100%(p=0.004). The success rate of manual CPR in driving at downtown was 67.4 土 15.7 in Van-type ambulance, but that was 93.4 土 5.2 in Truck-type ambulance (p=0.007). These results demonstrate that the performance of manual chest compression in a moving ambulance(Van type) is suboptimal. As the patient care area in the Van-type ambulance is much more spacious than that of the Truck-type ambulance, the diminution of compression efficacy in the smaller ambulance is consistent with the assumption that space is the most important factor in the ability to perform adequate CPR in a moving ambulance. Although the results were good in a truck-type ambulance, chest compression was performed for only 2 minutes. It is difficult for one person to deliver manual chest compression in a moving ambulance for a long period. Mechanical chest compression may be employed where manual compression is technically difficult to perform.

Key words: Manual chest compression, Mechanical chest compression, CPR in a moving ambulances