Can chest compression release rate or recoil velocity identify rescuer leaning in out-of-hospital cardiopulmonary resuscitation? 2018

James K Russell, and Digna M González-Otero, and Sofía Ruiz de Gauna, and Mohamud Daya, and Jesus Ruiz
Oregon Health & Science University, Portland, OR, 97239, USA. Electronic address: russejam@ohsu.edu.

Measurement of chest velocity has been proposed as an alternative method to identify responder leaning during cardiopulmonary resuscitation (CPR). Leaning is defined in terms of force, but no study has tested the utility of chest velocity in the presence of force measurements that directly measure leaning. We analyzed 1004 out-of-hospital cardiac arrest (OHCA) files collected with Q-CPR monitors in the Portland, Oregon, USA metro region from 2006 to 2017. Records contained accelerometry and force signals. For each chest compression, the following metrics were computed: minimum force at the end of the compression (Frelease), compression depth, compression rate, maximum chest velocity during recoil (vrecoil) and maximum rate of change in force during chest release (ʋrelease). A compression was classified as having leaning if Frelease was greater than 2.5 kg-f. The ability of vrecoil and ʋrelease to predict Frelease was estimated with generalized linear models, and their ability to identify leaning with logistic regression. The data set contained over 1.5 million chest compressions, 21% compliant with 2015 rate and depth guidelines for CPR (the G2015 population). Leaning was uncommon generally (12%), and less common in G2015 compliant compressions (5%). Leaning and Frelease decreased with both vrecoil and ʋrelease but with extensive overlap. Neither vrecoil nor ʋrelease, alone or in combination with chest compression rate and depth, reliably predicted leaning or Frelease. Leaning cannot be reliably identified from vrecoil or ʋrelease, alone or in combination with currently recommended chest compression metrics in out-of-hospital CPR.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006336 Heart Massage Rhythmic compression of the heart by pressure applied manually over the sternum (closed heart massage) or directly to the heart through an opening in the chest wall (open heart massage). It is done to reinstate and maintain circulation. (Dorland, 28th ed) Cardiac Massage,Cardiac Massages,Heart Massages,Massage, Cardiac,Massage, Heart,Massages, Cardiac,Massages, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face
D016887 Cardiopulmonary Resuscitation The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE. Basic Cardiac Life Support,CPR,Code Blue,Mouth-to-Mouth Resuscitation,Cardio-Pulmonary Resuscitation,Life Support, Basic Cardiac,Cardio Pulmonary Resuscitation,Mouth to Mouth Resuscitation,Mouth-to-Mouth Resuscitations,Resuscitation, Cardio-Pulmonary,Resuscitation, Cardiopulmonary,Resuscitation, Mouth-to-Mouth,Resuscitations, Mouth-to-Mouth
D058687 Out-of-Hospital Cardiac Arrest Occurrence of heart arrest in an individual when there is no immediate access to medical personnel or equipment. Out-of-Hospital Heart Arrest,Cardiac Arrest, Out-of-Hospital,Cardiac Arrests, Out-of-Hospital,Heart Arrest, Out-of-Hospital,Heart Arrests, Out-of-Hospital,Out of Hospital Cardiac Arrest,Out of Hospital Heart Arrest,Out-of-Hospital Cardiac Arrests,Out-of-Hospital Heart Arrests
D058996 Quality Improvement The attainment or process of attaining a new level of performance or quality. Improvement, Quality,Improvements, Quality,Quality Improvements
D061725 Accelerometry Qualitative and quantitative measurement of MOVEMENT patterns.

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