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. 2022 Nov:61:158-162.
doi: 10.1016/j.ajem.2022.08.059. Epub 2022 Sep 6.

Development of a model to measure the effect of off-balancing vectors on the delivery of high-quality CPR in a moving vehicle

Martin A C Manoukian  1 , John S Rose  2 , Samantha K Brown  2 , Elisabeth H Wynia  2 , Ian M Julie  2 , Bryn E Mumma  2
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Free article

Development of a model to measure the effect of off-balancing vectors on the delivery of high-quality CPR in a moving vehicle

Martin A C Manoukian et al. Am J Emerg Med. 2022 Nov.
Free article

Abstract

Aim: We sought to develop a model to measure the acceleration and jerk vectors affecting the performance of High-Quality Cardiopulmonary Resuscitation (HQ-CPR) during patient transport.

Methods: Three participants completed a total of eighteen rounds of compression only HQ-CPR in a moving vehicle. The vehicle was driven in a manner that either minimized or increased linear and angular vectors. The HQ-CPR variables measured were compression fraction (CF%), and percentages of compressions with correct depth > 5 cm (D%), rate 100-120 (R%), full recoil (FR%), and hand position (HP%). A composite HQ-CPR score was calculated: ((D% + R% + FR% + HP%)/4) * CF%). Linear and gyroscopic data were measured in the X, Y, and Z axes. The perceived difficulty in performing HQ-CPR was measured with the Borg Rating of Perceived Exertion Scale.

Results: HQ-CPR data, linear vector data, and gyroscopic data were successfully recorded in all trial evolutions. Univariate regression analysis demonstrated that HQ-CPR was negatively affected by increasing magnitudes of linear acceleration (B = -0.093%/m/s2, 95% CI [-0.17 - -0.02), p = 0.02], linear jerk (B = -0.134%/m/s3, 95% CI [-0.26 - -0.01], p = 0.04), angular velocity (B = -0.543%/radian/s, 95% CI [-0.98 - -0.11], p = 0.02), and angular acceleration (B = 0.863%/radian/s2, 95% CI [-1.69 - -0.03], p = 0.04). Increasing vectors were negatively associated with FR% and R%. No difference was seen in D%, HP%, or CF%. Borg Rating of Perceived Exertion was greater in dynamic driving evolutions (8 ± 1 vs 3.5 ± 1.53, p = 0.02).

Conclusion: This model reliably measured linear and angular off-balancing vectors experienced during the delivery of HQ-CPR in a moving vehicle. In this preliminary report, compression rate and full recoil appear to be HQ-CPR variables most affected in a moving vehicle.

Keywords: Acceleration; Cardiopulmonary resuscitation; Jerk; Off-balancing vectors; Out-of-hospital cardiac arrest; Transportation.

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Conflict of interest statement

Declaration of Competing Interest The authors were provided the use of a Resusci-Anne QCPR manikin by Laerdal which was then returned. The authors did not receive any funding for the research conducted in this manuscript. The authors have no further conflict of interest to report.

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