An optimal chest compression technique using personal protective equipment during resuscitation in the COVID-19 pandemic: a randomized crossover simulation study.

Abstract

Cardiopulmonary resuscitation (CPR) with the use of personal protective equipment (PPE) for aerosol generating procedures (AGP) in patients with suspected/confirmed COVID-19 remains challenging. The aim of this study was to compare three chest compression methods applied by paramedics wearing PPE. The single-blinded, multi-centre, randomized, cross-over simulation study involved 67 paramedics wearing PPE AGP. They performed 2-minute continuous chest compressions (CCs) in an adult patient with suspected/confirmed COVID-19 in three scenarios: (a) manual CCs; (b) CCs with a TrueCPR feedback device; (c) CCs with a LUCAS3 mechanical CC device. CC depth when using LUCAS3 compared with TrueCPR and manual CC was more frequently correct 51 [50-55] vs. 47 [43-52] vs. 43 [38-46]mm; P = 0.005) and more often performed correctly regarding CC rate 102 [100-102] vs. 105 [98-1114] vs. 116 [112-129] compressions per minute; P = 0.027) and chest recoil 100 [98-100] vs. 83 [60-92] vs. 39 [25-50]%; P = 0.001). A detailed analysis of 2-minute resuscitation with manual CCs showed a decrease in compression depth and full chest recoil after 1 minute of CCs. We show that during simulated resuscitation with the use of PPE AGP in patients with suspected/confirmed COVID-19, CC with LUCAS3 compared with manual CCs as well as a TrueCPR feedback device essentially increased CC quality. In the case of manual CCs by paramedics dressed in PPE AGP, it is advisable to change the person performing CC every minute.

Publication
In Kardiologia polska
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