Abstract
Background
The medical priority dispatch system (MPDS®) assists lay rescuers in protocol-driven
telephone-assisted cardiopulmonary resuscitation (CPR).
Objective
Our aim was to clarify which CPR instruction leads to sufficient compression depth.
Methods
This was an investigator-blinded, randomized, parallel group, simulation study to
investigate 10 min of chest compressions after the instruction “push down firmly 5 cm”
vs. “push as hard as you can.” Primary outcome was defined as compression depth. Secondary
outcomes were participants exertion measured by Borg scale, provider's systolic and
diastolic blood pressure, and quality values measured by the skill-reporting program
of the Resusci® Anne Simulator manikin. For the analysis of the primary outcome, we used a linear
random intercept model to allow for the repeated measurements with the intervention
as a covariate.
Results
Thirteen participants were allocated to control and intervention. One participant
(intervention) dropped out after min 7 because of exhaustion. Primary outcome showed
a mean compression depth of 44.1 mm, with an inter-individual standard deviation (SDb) of 13.0 mm and an intra-individual standard deviation (SDw) of 6.7 mm for the control group vs. 46.1 mm and a SDb of 9.0 mm and SDw of 10.3 mm for the intervention group (difference: 1.9; 95% confidence interval −6.9
to 10.8; p = 0.66). Secondary outcomes showed no difference for exhaustion and CPR-quality values.
Conclusions
There is no difference in compression depth, quality of CPR, or physical strain on
lay rescuers using the initial instruction “push as hard as you can” vs. the standard
MPDS® instruction “push down firmly 5 cm.”
Keywords
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Article info
Publication history
Published online: November 14, 2013
Accepted:
August 15,
2013
Received in revised form:
May 3,
2013
Received:
February 28,
2013
Footnotes
Trial registry: www.controlled-trials.com ISRCTN51784217.
The current study was supported by RORACO, which provided the Laerdal Resusci® Anne Simulator manikin with PC skill-reporting program, CHEMOMEDICA, which provided the Argus PRO LIFE, and NOTRUF NOE, which provided the certified dispatcher and the goodie packs for the voluntary participants.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
