title: CPR using the lifeline ARM mechanical chest compression device: a randomized, crossover, manikin trial.
abstract: BACKGROUND
  European Resuscitation Council as well as American Heart Association guidelines for cardiopulmonary resuscitation (CPR) stress the importance of uninterrupted and effective chest compressions (CCs). Manual CPR decreases in quality of CCs over time because of fatigue which impacts outcome. We report the first study with the Lifeline ARM automated CC device for providing uninterrupted CCs.
  
  
  METHODS
  Seventy-eight paramedics participated in this randomized, crossover, manikin trial. We compared the fraction of effective CCs between manual CPR and automated CPR using the ARM.
  
  
  RESULTS
  Using the ARM during resuscitation resulted in a higher percentage of effective CCs (100/min [interquartile range, 99-100]) compared with manual CCs (43/min [interquartile range, 39-46]; P<.001). The number of effective CCs decreased less over time with the ARM (P<.001), more often reached the required depth of 5 cm (97% vs 63%, P<.001), and more often reached the recommended CC rate (P<.001). The median tidal volume was higher and hands-off time was lower when using the ARM.
  
  
  CONCLUSIONS
  Mechanical CCs in our study adhere more closely to current guidelines than manual CCs. The Lifeline ARM provides more effective CCs, more ventilation time and minute volume, less hands-off time, and less decrease in effective CCs over time compared with manual Basic Life Support and might therefore impact outcome.
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Szarpak
authors.affiliation: Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Zenon
authors.initials: Z
authors.lastname: Truszewski
authors.affiliation: Department of Nephrology Nursing, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Czyzewski
authors.affiliation: Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Frass
authors.affiliation: Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria. Electronic address: Oliver.robak@meduniwien.ac.at.
authors.forename: Oliver
authors.initials: O
authors.lastname: Robak
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods; D018592:Cross-Over Studies; D004634:Emergency Medical Technicians; D004867:Equipment Design; D005221:Fatigue; D005260:Female; D019983:Guideline Adherence; D006336:Heart Massage / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008348:Manikins; D017410:Practice Guidelines as Topic; D055815:Young Adult