Abstract 16819: Comparison of Manual vs. Mechanical Chest Compression Quality During Prehospital Cardiac Resuscitation

Background: Cardiopulmonary resuscitation (CPR) quality is strongly linked to outcomes following out-of-hospital cardiac arrest (OHCA). However, manual CPR quality varies and has risk to providers. We hypothesized that use of a mechanical CPR device might provide higher quality CPR than manual CPR during the technically challenging periods of OHCA resuscitation such as packaging, loading, and transporting patients. Methods: Cases of OHCA at a single site from 10/2008-10/2016 were identified. Two CPR quality metrics, chest compression fraction (CCfr) and CC rate (CCra), measured using accelerometer-based technology (E & X-Series), were compared between 3 groups: packaging (terminal 5 minutes on scene), loading (terminal 3 minutes on scene), and transport. Mechanical CPR was performed using (AutoPulse®, ZOLL Medical) while most cases of manual CPR were performed with real-time audiovisual chest compression feedback enabled (Real CPR Help®). To compare manual CPR [metronome rate of 100 beats per minutes (bmp)] and mechanical CPR (set CCra of 80 bpm) the median proportion of time in which CCra was within +/-5 bmp of the target range (pCCra) and the mean CCfr is reported using the Wilcoxon rank-sum test. Results: 357 cases were reviewed and 239 excluded: no age or age Conclusion: In adults with OHCA, use of a mechanical CPR device was associated with higher CCfr during patient packaging and loading and a higher proportion of time within the target CCra rate during all time periods. Use of mechanical CPR may improve CPR quality without exposing providers to the risks of performing manual CPR during the packaging, loading, and transport of OHCA patients.