title: A stabilization device that promotes the efficiency of cardiopulmonary resuscitation during ambulance transportation to the level as under non-moving conditions.
abstract: BACKGROUND
  The survival rate of patients with out-of-hospital cardiac arrest is low, and measures to improve the quality of cardiopulmonary resuscitation (CPR) during ambulance transportation are desirable. We designed a stabilization device, and in a randomized crossover trial we found performing CPR in a moving ambulance with the device (MD) could achieve better efficiency than that without the device (MND), but the efficiency was lower than that in a non-moving ambulance (NM).
  
  
  OBJECTIVE
  To evaluate whether a modified version of the stabilization device, can promote further the quality of CPR during ambulance transportation.
  
  
  METHODS
  Participants of the previous study were recruited, and they performed CPR for 10 minutes in a moving ambulance with the modified version of the stabilization device (MVSD). The primary outcomes were effective chest compressions and no-flow fraction recorded by a skill-reporter manikin. The secondary outcomes included back pain, physiological parameters, and the participants' rating about the device after performing CPR.
  
  
  RESULTS
  The overall effective compressions in 10 minutes were 86.4±17.5% for NM, 60.9±14.6% for MND, 69.7±22.4% for MD, and 86.6%±13.2% for MVSD (p<0.001). Whereas changes in back pain severity and physiology parameters were similar under all conditions, MVSD had the lowest no-flow fraction. Differences in effective compressions and the no-flow fraction between MVSD and NM did not reach statistical significance.
  
  
  CONCLUSIONS
  The use of the modified device can improve quality of CPR in a moving ambulance to a level similar to that in a non-moving condition without increasing the severity of back pain.
authors.affiliation: Department of Emergency Medicine, China Medical University-An Nan Hospital, Taichung, Taiwan; Department of Environmental and Occupational Health College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Emergency Medicine, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chia-Yi, Taiwan.
authors.forename: Ning-Ping
authors.initials: NP
authors.lastname: Foo
authors.affiliation: Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Jer-Hao
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
authors.forename: Shih-Bin
authors.initials: SB
authors.lastname: Su
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Medicine, Tainan Municipal Hospital, Tainan, Taiwan.
authors.forename: Kow-Tong
authors.initials: KT
authors.lastname: Chen
authors.affiliation: Division of Emergency Medical Services, Tainan City Fire Bureau, Tainan, Taiwan.
authors.forename: Ching-Fa
authors.initials: CF
authors.lastname: Cheng
authors.affiliation: Department of Mechanical Engineering, Southern Taiwan University of Science and Technology,Tainan, Taiwan.
authors.forename: Pei-Chung
authors.initials: PC
authors.lastname: Chen
authors.affiliation: Department of Mechanical Engineering, Southern Taiwan University of Science and Technology,Tainan, Taiwan.
authors.forename: Tsung-Yi
authors.initials: TY
authors.lastname: Lin
authors.affiliation: Department of Environmental and Occupational Health College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
mesh_terms: D000368:Aged; D000552:Ambulances; D001794:Blood Pressure; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006323:Heart Arrest / Q000517:prevention & control / Q000628:therapy; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000473:pathology; D014187:Transportation of Patients / Q000379:methods*