title: CPR quality during out-of-hospital cardiac arrest transport.
abstract: Previous studies have demonstrated significant associations between cardiopulmonary resuscitation (CPR) quality metrics and survival to hospital discharge. No adequately powered study has explored the relationship between location of resuscitation (scene vs. transport) and CPR quality.
  
  
  
  We analyzed CPR quality data from treated adult OHCA occurring over a 40 month period beginning January 1, 2013 from the Rescu Epistry-cardiac arrest database. High quality CPR was defined as chest compression fraction (CCF) >0.7, compression rate >100/min and compression depth >5.0cm. Our primary objective was to compare the proportion of resuscitations for which all CPR quality benchmarks were met between scene and transport phases of resuscitation. Our secondary objectives were to compare the quality of CPR between the scene phase and transport phase of resuscitation.
  
  
  
  The proportion of patients with high quality CPR was similar on scene compared to during transport (45.8% vs. 42.5%; ∆ 3.3 %; 95% CI: -1.4, 8.1). Regarding individual CPR metrics, median compression rate was higher on scene compared to transport (105.8 compressions per minute (cpm) vs. 102.0cpm; ∆ 3.8cpm; 95% CI: 2.5, 4.0), while median compression depth (5.56cm vs. 5.33cm; ∆ 0.23cm; 95% CI: 0.12, 0.26) and median CCF (0.95 vs. 0.87; ∆ 0.08; 95% CI: 0.07, 0.08) were higher during the transport phase.
  
  
  
  High quality CPR metrics were similar in both (scene and transport) locations of resuscitation. These results suggest that high quality, manual compressions can be performed by prehospital providers regardless of location.
authors.affiliation: Sunnybrook Centre for Prehospital Medicine, Toronto, ON, Canada; University of Toronto, Department of Family and Community Medicine, Division of Emergency Medicine, Toronto, ON, Canada; Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada. Electronic address: Sheldon.Cheskes@sunnybrook.ca.
authors.forename: Sheldon
authors.initials: S
authors.lastname: Cheskes
authors.affiliation: Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada.
authors.forename: Adam
authors.initials: A
authors.lastname: Byers
authors.affiliation: Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada.
authors.forename: Cathy
authors.initials: C
authors.lastname: Zhan
authors.affiliation: Sunnybrook Centre for Prehospital Medicine, Toronto, ON, Canada; University of Toronto, Department of Medicine, Division of Emergency Medicine, Toronto, ON, Canada.
authors.forename: P Richard
authors.initials: PR
authors.lastname: Verbeek
authors.affiliation: Sunnybrook Health Sciences Centre, Division of Cardiology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Dennis
authors.initials: D
authors.lastname: Ko
authors.affiliation: Sunnybrook Centre for Prehospital Medicine, Toronto, ON, Canada; Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada; York Regional Paramedic Services, Toronto, ON, Canada.
authors.forename: Ian R
authors.initials: IR
authors.lastname: Drennan
authors.affiliation: Sunnybrook Centre for Prehospital Medicine, Toronto, ON, Canada; Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada.
authors.forename: Jason E
authors.initials: JE
authors.lastname: Buick
authors.affiliation: Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada; Department of Emergency Medicine, Queen's University, Kingston, ON, Canada.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Brooks
authors.affiliation: University of Toronto, Department of Medicine, Division of Emergency Medicine, Toronto, ON, Canada; Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Lin
authors.affiliation: University of Toronto, Department of Medicine, Division of Emergency Medicine, Toronto, ON, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Taher
authors.affiliation: University of Toronto, Department of Medicine, Division of Emergency Medicine, Toronto, ON, Canada; Rescu, Li Ka Shing Knowledge Institute, St. Michaels Hospital, Toronto, ON, Canada.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Morrison
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking / Q000379:methods; D016887:Cardiopulmonary Resuscitation / Q000592:standards* / Q000706:statistics & numerical data; D016208:Databases, Factual; D004632:Emergency Medical Services / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006336:Heart Massage / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D011787:Quality of Health Care; D013997:Time Factors
keywords: Cardiac arrest; Cardiopulmonary resuscitation; Emergency medical services; Paramedic; Resuscitation; Survival