# Comparison of Cardiopulmonary Resuscitation Quality in a Simulated Model: At Incident Scene vs During EMS Transport

## TL;DR

This study compares the quality of CPR performed at the incident scene versus during ambulance transport, finding differences in compression rate and depth.

## Contribution

The study provides empirical evidence on how CPR quality changes during ambulance transport compared to on-site resuscitation.

## Key findings

- Chest compressions during transport were faster but shallower than recommended guidelines.
- Correct hand placement was similar in both scenarios.
- Transportation may negatively affect CPR quality parameters.

## Abstract

Out-of-hospital cardiac arrest remains a leading cause of death and significantly impacts global health outcomes. International guidelines emphasize the importance of high-quality CPR (cardiopulmonary resuscitation).

Our goal was to compare CPR efficiency using the criteria recommended by international guidelines between two out-of-hospital cardiac arrest intervention scenarios: CPR at the incident site; and CPR during patient transport to the hospital by emergency medical services.

In each of the two scenarios, five full two-minute cycles of cardiac compression were applied to a manikin according to international guidelines. The CPR quality parameters were chest compression rate, chest compression depth recorded by the manikin, and investigator-evaluated correct hand placement on the manikin.

We analyzed data from 240 CPR cycles provided by 24 healthcare professionals. The mean chest compression rate was higher (120.5±10.9/minutes vs 125.3±14.7/min, P = .001) and the mean chest compression depth was shallower (43.9±6.6 millimeters [mm] vs 37.9±7.2 mm, P = .001) in the on-the-move group. The two groups’ appropriate hand placement rates were similar (92.1±5.4% vs 92.2±4.5%, P = .48)

In this study, the moving ambulance simulation demonstrated that chest compressions were administered at a rate exceeding recommended guidelines and at a shallower depth than recommended, while the frequency of correct hand placement remained comparable. If the patient requires transportation from the scene of the incident, the healthcare team must be aware of the potential adverse effects on the chest compression quality.