Effect of mattress and bed frame deflection on real chest compression depth measured with two CPR sensors

• Published in: Resuscitation 2014-06, Vol.85 (6), p.840-843
• Main Authors: Sainio, Marko, Hellevuo, Heidi, Huhtala, Heini, Hoppu, Sanna, Eilevstjønn, Joar, Tenhunen, Jyrki, Olkkola, Klaus T
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Beds; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Emergency; Equipment Design; Feedback; Female; Humans; Male; Mattresses; Middle Aged; Pressure; Prospective Studies; Resuscitation; Sensor
• ISSN: 0300-9572; 1873-1570; 1873-1570
• DOI: 10.1016/j.resuscitation.2014.03.009

Abstract Aim Implementation of chest compression (CC) feedback devices with a single force and deflection sensor (FDS) may improve the quality of CPR. However, CC depth may be overestimated if the patient is on a compliant surface. We have measured the true CC depth during in-hospital CPR using two FDSs on different bed and mattress types. Methods This prospective observational study was conducted at Tampere University Hospital between August 2011 and September 2012. During in-hospital CPR one FDS was placed between the rescuer's hand and the patient's chest, with the second attached to the backboard between the patient's back and the mattress. The real CC depth was calculated as the difference between the total depth from upper FDS to lower FDS. Results Ten cardiac arrests on three different bed and mattress types yielded 10,868 CCs for data analyses. The mean (SD) mattress/bed frame effect was 12.8 (4) mm on a standard hospital bed with a gel mattress, 12.4 (4) mm on an emergency room stretcher with a thin gel mattress and 14.1 (3) mm on an ICU bed with an emptied air mattress. The proportion of CCs with an adequate depth (≥50 mm) decreased on all mattress types after compensating for the mattress/bed frame effect from 94 to 64%, 98 to 76% and 91 to 17%, in standard hospital bed, emergency room stretcher and ICU bed, respectively ( p < 0.001). Conclusion The use of FDS without real-time correction for deflection may result in CC depth not reaching the recommended depth of 50 mm.