Quality of resuscitation: flight attendants in an airplane simulator use a new mechanical resuscitation device--a randomized simulation study.
OBJECTIVE
Cardiopulmonary resuscitation (CPR) during flight is challenging and has to be sustained for long periods. In this setting a mechanical-resuscitation-device (MRD) might improve performance. In this study we compared the quality of resuscitation of trained flight attendants practicing either standard basic life support (BLS) or using a MRD in a cabin-simulator.


METHODS
Prospective, open, randomized and crossover simulation study. Study participants, competent in standard BLS were trained to use the MRD to deliver both chest compressions and ventilation. 39 teams of two rescuers resuscitated a manikin for 12 min in random order, standard BLS or mechanically assisted resuscitation. Primary outcome was "absolute hands-off time" (sum of all periods during which no hand was placed on the chest minus ventilation time). Various parameters describing the quality of chest compression and ventilation were analysed as secondary outcome parameters.


RESULTS
Use of the MRD led to significantly less "absolute hands-off time" (164±33 s vs. 205±42 s, p<0.001). The quality of chest compression was comparable among groups, except for a higher compression rate in the standard BLS group (123±14 min(-1) vs. 95±11 min(-1), p<0.001). Tidal volume was higher in the standard BLS group (0.48±0.14 l vs. 0.34±0.13 l, p<0.001), but we registered fewer gastric inflations in the MRD group (0.4±0.3% vs. 16.6±16.9%, p<0.001).


CONCLUSIONS
Using the MRD resulted in significantly less "absolute hands-off time", but less effective ventilation. The translation of higher chest compression rate into better outcome, as shown in other studies previously, has to be investigated in another human outcome study.
Department of Anaesthesia, General Intensive Care and Pain Control, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Medical University Vienna, Austria.
Henrik
H
Fischer
Stephanie
S
Neuhold
Eva
E
Hochbrugger
Barbara
B
Steinlechner
Herbert
H
Koinig
Ljubisa
L
Milosevic
Christof
C
Havel
Sophie
S
Frantal
Robert
R
Greif
D000328:Adult; D000401:Aircraft; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000592:standards*; D003198:Computer Simulation; D018592:Cross-Over Studies; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008348:Manikins; D011446:Prospective Studies; D011786:Quality Control; D013997:Time Factors