title: Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting.
abstract: BACKGROUND
  Ambulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island.
  
  
  METHODS
  The Basic Life Support (BLS) and Automated External Defibrillator (AED) skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring sheet. One sample t test was used to analyze the deviation from optimal care according to the 2005 guidelines. After each assessment, individual feedback was given.
  
  
  RESULTS
  On 3 consecutive days, we assessed the individual EMS teams responding to OHCA on the island. Overall, 70% of the maximal points were achieved. The hands-off ratio was 40%. Correct compression/ventilation ratio (30:2) was used by 80%. A mean compression depth of 40-50 mm was achieved by 55% and the mean compression depth was 42 mm (SD 7 mm). The mean compression rate was 123 per min (SD 15/min). The mean tidal volume was 746 ml (SD 221 ml). Only the mean tidal volume deviated significantly from the recommended (p = 0.01). During the rhythm analysis, 65% did not perform any visual or verbal safety check.
  
  
  CONCLUSIONS
  The EMS providers achieved 70% of the maximal points. Tidal volumes were larger than recommended when mask ventilation was applied. Chest compression depth was optimally performed by 55% of the staff. Defibrillation safety checks were not performed in 65% of EMS providers.
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark. mnielsen.anne@gmail.com
authors.forename: Anne Møller
authors.initials: AM
authors.lastname: Nielsen
authors.forename: Dan Lou
authors.initials: DL
authors.lastname: Isbye
authors.forename: Freddy Knudsen
authors.initials: FK
authors.lastname: Lippert
authors.forename: Lars Simon
authors.initials: LS
authors.lastname: Rasmussen
mesh_terms: D000465:Algorithms; D047548:Defibrillators; D003718:Denmark; D004632:Emergency Medical Services / Q000592:standards*; D004634:Emergency Medical Technicians / Q000592:standards*; D005260:Female; D006801:Humans; D008020:Life Support Care / Q000592:standards*; D008297:Male; D008348:Manikins; D017410:Practice Guidelines as Topic; D011361:Professional Competence; D012424:Rural Population