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The Impact of Backboard Placement on Chest Compression Quality: A Mannequin Study

Published online by Cambridge University Press:  14 April 2019

Erkman Sanri Open the ORCID record for Erkman Sanri [Opens in a new window]  and
Sinan Karacabey
Erkman Sanri*
Affiliation:
Department of Emergency Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
Sinan Karacabey
Affiliation:
Department of Emergency Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
*
Correspondence: Erkman Sanri, MD, Emergency Medicine Specialist, Marmara University Faculty of Medicine, Department of Emergency Medicine, Istanbul, Turkey E-mail: [email protected]
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Abstract

Introduction:

High-quality chest compressions (CCs) are associated with high survival rates and good neurological outcomes in cardiac arrest patients. The 2015 American Heart Association (AHA; Dallas, Texas USA) Guidelines for Resuscitation defined and recommended high-quality CCs during cardiopulmonary resuscitation (CPR). However, CPR providers struggle to achieve high-quality CCs. There is a debate about the use of backboards during CPR in literature. Some studies suggest backboards improve CC quality, whereas others suggest that backboards can cause delays. This is the first study to evaluate all three components of high-quality CCs: compression depth, recoil depth, and rate, at the same time with a high number of subjects. This study evaluated the impact of backboards on CC quality during CPR. The primary outcome was the difference in successful CC rates between two groups.

Methods:

This was a randomized, controlled, single-blinded study using a high-fidelity mannequin. The successful CC rates, means CC depths, recoil depths, and rates achieved by 6th-grade undergraduate medical students during two minutes of CPR were compared between two randomized groups: an experimental group (backboard present) and a control group (no backboard).

Results:

Fifty-one of all 101 subjects (50.5%) were female, and the mean age was 23.9 (SD = 1.01) years. The number and the proportion of successful CCs were significantly higher in the experimental group (34; 66.7%) when compared to the control group (19; 38.0%; P = .0041). The difference in mean values of CC depth, recoil depth, and CC rate was significantly higher in the experiment group.

Conclusion:

The results suggest that using a backboard during CPR improves the quality of CCs in accordance with the 2015 AHA Guidelines.

Sanri E, Karacabey S. The impact of backboard placement on chest compression quality: a mannequin study. Prehosp Disaster Med. 2019;34(2):182–187

Keywords

backboardchest compressionchest compression depthchest compression ratemannequin
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 2 , April 2019 , pp. 182 - 187
Copyright
© World Association for Disaster and Emergency Medicine 2019 

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Footnotes

Conflicts of interest: none

References

Cloete, G, Dellimore, KH, Scheffer, C. Comparison of experimental chest compression data to a theoretical model for the mechanics of constant peak displacement cardiopulmonary resuscitation. Acad Emerg Med. 2011;18(11):1167–1176.CrossRefGoogle ScholarPubMed
Cheng, A, Belanger, C, Wan, B, et al. Effect of emergency department mattress compressibility on chest compression depth using a standardized cardiopulmonary resuscitation board, a slider transfer board, and a flat spine board: a simulation-based study. Simul Healthc. 2017;12(6):364–369.Google Scholar
Nolan, JP, Perkins, GD, Soar, J. Chest compression rate: where is the sweet spot? Circulation. 2012;125(24):2968–2970.CrossRefGoogle ScholarPubMed
Brennan, EE, McGraw, RC, Brooks, SC. Accuracy of instructor assessment of chest compression quality during simulated resuscitation. CJEM. 2016;18(4):276–282.CrossRefGoogle ScholarPubMed
Kleinman, ME, Brennan, EE, Goldberger, ZD, et al. Part 5: Adult Basic Life Support and cardiopulmonary resuscitation quality: 2015 American Heart Association Guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S414–435.CrossRefGoogle ScholarPubMed
Scott, G, Barron, T, Gardett, I, et al. Can a software-based metronome tool enhance compression rate in a realistic 911 call scenario without adversely impacting compression depth for dispatcher-assisted CPR? Prehosp Disaster Med. 2018;33(4):399–405.CrossRefGoogle Scholar
Stiell, IG, Brown, SP, Christenson, J, et al. What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation? Crit Care Med. 2012;40(4):1192–1198.CrossRefGoogle ScholarPubMed
Vadeboncoeur, T, Stolz, U, Panchal, A, et al. Chest compression depth and survival in out-of-hospital cardiac arrest. Resuscitation. 2014;85(2):182–188.CrossRefGoogle ScholarPubMed
Lin, Y, Wan, B, Belanger, C, et al. Reducing the impact of intensive care unit mattress compressibility during CPR: a simulation-based study. Adv Simul (Lond). 2017;2:22.CrossRefGoogle ScholarPubMed
Cheng, A, Brown, LL, Duff, JP, et al. Improving cardiopulmonary resuscitation with a CPR feedback device and refresher simulations (CPR CARES Study): a randomized clinical trial. JAMA Pediatr. 2015;169(2):137–144.CrossRefGoogle ScholarPubMed
Ruiz de Gauna, S, Gonzalez-Otero, DM, Ruiz, J, et al. A feasibility study for measuring accurate chest compression depth and rate on soft surfaces using two accelerometers and spectral analysis. Biomed Res Int. 2016;2016:6596040.CrossRefGoogle ScholarPubMed
Noordergraaf, GJ, Paulussen, IW, Venema, A, et al. The impact of compliant surfaces on in-hospital chest compressions: effects of common mattresses and a backboard. Resuscitation. 2009;80(5):546–552.CrossRefGoogle Scholar
Sainio, M, Hellevuo, H, Huhtala, H, et al. Effect of mattress and bed frame deflection on real chest compression depth measured with two CPR sensors. Resuscitation. 2014;85(6):840–843.CrossRefGoogle ScholarPubMed
Nishisaki, A, Nysaether, J, Sutton, R, et al. Effect of mattress deflection on CPR quality assessment for older children and adolescents. Resuscitation. 2009;80(5):540–545.CrossRefGoogle ScholarPubMed
Sato, H, Komasawa, N, Ueki, R, et al. Backboard insertion in the operating table increases chest compression depth: a manikin study. J Anesth. 2011;25(5):770–772.CrossRefGoogle ScholarPubMed
Boe, JM, Babbs, CF. Mechanics of cardiopulmonary resuscitation performed with the patient on a soft bed vs a hard surface. Acad Emerg Med. 1999;6(7):754–757.CrossRefGoogle Scholar
Fischer, EJ, Mayrand, K, Ten Eyck, RP. Effect of a backboard on compression depth during cardiac arrest in the ED: a simulation study. Am J Emerg Med. 2016;34(2):274–277.CrossRefGoogle ScholarPubMed
Travers, AH, Perkins, GD, Berg, RA, et al. Part 3: Adult Basic Life Support and automated external defibrillation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2015;132(16 Suppl 1):S51–83.CrossRefGoogle ScholarPubMed
Sutton, RM, French, B, Niles, DE, et al. 2010 American Heart Association recommended compression depths during pediatric in-hospital resuscitations are associated with survival. Resuscitation. 2014;85(9):1179–1184.CrossRefGoogle Scholar
Nishisaki, A, Maltese, MR, Niles, DE, et al. Backboards are important when chest compressions are provided on a soft mattress. Resuscitation. 2012;83(8):1013–1020.CrossRefGoogle ScholarPubMed
Andersen, LO, Isbye, DL, Rasmussen, LS. Increasing compression depth during manikin CPR using a simple backboard. Acta Anaesthesiol Scand. 2007;51(6):747–750.CrossRefGoogle ScholarPubMed
Perkins, GD, Smith, CM, Augre, C, et al. Effects of a backboard, bed height, and operator position on compression depth during simulated resuscitation. Intensive Care Med. 2006;32(10):1632–1635.CrossRefGoogle ScholarPubMed
Schulz, KF, Altman, DG, Moher, D, et al. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. BMJ. 2010;340:c332.CrossRefGoogle Scholar
Wieczorek, W, Smereka, J, Szarpak, L, et al. Which position for resuscitation should we take? A randomized crossover manikin study. Am J Emerg Med. 2018;36(5):899–900.CrossRefGoogle Scholar
Kramer-Johansen, J, Myklebust, H, Wik, L, et al. Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study. Resuscitation. 2006;71(3):283–292.CrossRefGoogle ScholarPubMed
Babbs, CF, Voorhees, WD, Fitzgerald, KR, et al. Relationship of blood pressure and flow during CPR to chest compression amplitude: evidence for an effective compression threshold. Ann Emerg Med. 1983;12(9):527–532.CrossRefGoogle ScholarPubMed
Putzer, G, Fiala, A, Braun, P, et al. Manual versus mechanical chest compressions on surfaces of varying softness with or without backboards: a randomized, cross-over manikin study. J Emerg Med. 2016;50(4):594–600.CrossRefGoogle ScholarPubMed
Oh, J, Chee, Y, Song, Y, et al. A novel method to decrease mattress compression during CPR using a mattress compression cover and a vacuum pump. Resuscitation. 2013;84(7):987–991.CrossRefGoogle Scholar