Comparison of Continuous Versus Interrupted Chest Compressions during CPR in a Rural Community
Keywords:resuscitation, cardiopulmonary resuscitation, resuscitation orders, emergency medical service, rural hospital
Introduction. Cardiopulmonary resuscitation (CPR) in patients
with out-of-hospital cardiac arrest (OHCA) have interruption of
manual chest compressions for airway management and breathing
when performed by medical personnel trained by Advanced Cardiac
Life Support (ACLS) standards. This interruption likely reduces
blood flow and possibly survival. Traditional CPR (30:2 compressions
to ventilations) was compared with continuous chest compressions,
CCC (also termed Cardiocerebral Resuscitation, CCR) in a rural
Methods. A retrospective cohort analysis of three years of traditional
CPR (June 2008 - May 2011) for OHCA was compared to
three years of using CCC protocols (June 2011 - May 2014). Primary
outcomes were survival at one and six months.
Results. There were 58 0HCA patients in the six year study period
(June 2008 - May 2014). Forty (69%) received CPR and 18 (31%)
received CCC. Two (5%) survived at least one month with CPR and
eight (44%) survived at least one month with CCC (p = 0.0007).
After six months, 0/40 (0%) who received CPR had survived and
6/18 (33%) who received CCC survived (p = 0.0018). For the patient
found in ventricular fibrillation or tachycardia (a shockable rhythm),
0/13 (0.0%) survived one month after CPR and 7/9 (78%) survived
with CCC (p < 0.01). After six months 0/13 (0.0%) survived with
CPR and 6/9 (67%) survived with CCC (p < 0.05).
Conclusions. For patients in a rural environment with OHCA, CCC
had a more favorable outcome than traditional CPR. For the patient
found in ventricular fibrillation or ventricular tachycardia, there was
a profound survival benefit of CCC over CPR.
Kans J Med 2018;11(4):110-113.
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