Obstacles delaying the prompt deployment of piston-type mechanical cardiopulmonary resuscitation devices during emergency department resuscitation: A video-recording and time-motion study

Edward Pei Chuan Huang, Hui Chih Wang, Patrick Chow In Ko, Anna Marie Chang, Chia Ming Fu, Jiun Wei Chen, Yen Chen Liao, Hung Chieh Liu, Yao De Fang, Chih Wei Yang, Wen Chu Chiang, Matthew Huei Ming Ma, Shyr Chyr Chen

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: The quality of cardiopulmonary resuscitation (CPR) is important to survival after cardiac arrest. Mechanical devices (MD) provide constant CPR, but their effectiveness may be affected by deployment timeliness. Objectives: To identify the timeliness of the overall and of each essential step in the deployment of a piston-type MD during emergency department (ED) resuscitation, and to identify factors associated with delayed MD deployment by video recordings. Methods: Between December 2005 and December 2008, video clips from resuscitations with CPR sessions using a MD in the ED were reviewed using time-motion analyses. The overall deployment timeliness and the time spent on each essential step of deployment were measured. Results: There were 37 CPR recordings that used a MD. Deployment of MD took an average 122.6. ±. 57.8. s. The 3 most time-consuming steps were: (1) setting the device (57.8. ±. 38.3. s), (2) positioning the patient (33.4. ±. 38.0. s), and (3) positioning the device (14.7. ±. 9.5. s). Total no flow time was 89.1. ±. 41.2. s (72.7% of total time) and associated with the 3 most time-consuming steps. There was no difference in the total timeliness, no-flow time, and no-flow ratio between different rescuer numbers, time of day of the resuscitation, or body size of patients. Conclusions: Rescuers spent a significant amount of time on MD deployment, leading to long no-flow times. Lack of familiarity with the device and positioning strategy were associated with poor performance. Additional training in device deployment strategies are required to improve the benefits of mechanical CPR.

Original languageEnglish (US)
Pages (from-to)1208-1213
Number of pages6
JournalResuscitation
Volume84
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • Cardiopulmonary resuscitation (CPR)
  • Mechanical devices
  • No-flow time
  • Quality
  • Time-motion analysis
  • Video-recording

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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