[Investigation of factors influencing the quality of chest compressions in dogs using a realistic thorax model].

SUBJECT AND

OBJECTIVE

The quality of chest compressions is crucial for the success of resuscitation. To date, there is limited veterinary medical evidence on this topic. The influence of the rescuer's position on the quality of resuscitation was investigated in order to determine the most effective approach.

MATERIAL AND

METHODS

Using a realistic thorax model equipped with an "intracorporeal" pressure sensor, 30 participants performed chest compressions for 5 minutes each in three scenarios (randomized order): in Scenario 1 kneeling beside the model; in Scenarios 2 and 3 standing at a table without (Scenario 2) or, according to preference, with one or two steps (Scenario 3). Compression pressure and rate were measured, and parameters of force decline were calculated. Demographic data and self-assessment regarding compression quality were collected. Statistical analysis was performed using non-parametric methods; the significance level was set at p<0.05.

RESULTS

Forty-three of 90 trials (48%) were terminated by the participant before completion of 5 minutes. In Scenario 2, compressions were stopped significantly earlier after 107 s (±76) compared to Scenario 1 (165±55 s; p=0.009) and Scenario 3 (122±66 s; p=0.047). In Scenario 2, significantly lower compression pressures were achieved (median 54.8 mmHg; IQR 38.9-72.9) compared to Scenario 1 (64.8 mmHg; IQR 48.5-83.6) and Scenario 3 (73.7 mmHg; IQR 55.2-94.3). The significantly different mean compression rates indicated a tendency toward rates below the recommended range in Scenario 1 and above the recommended range (100-120/min) in Scenario 3. A decrease in compression pressure below its median (as a measure of fatigue) occurred after 90 s (±28) in Scenario 1 and after 70 s (±45) and 94 s (±49) in Scenarios 2 and 3, respectively. There was no or only weak correlation between self-assessed fatigue and compression quality and the measured parameters.

CONCLUSION

Standing at a treatment table without a step is less effective for performing chest compressions than standing with a step or kneeling on the floor. The marked decline in compression quality after 2-3 minutes and the inability to accurately assess one's own fatigue support current recommendations to switch the person performing compressions every 2 minutes.

CLINICAL RELEVANCE: This study supports the recommendations of the RECOVER guidelines.