EMS World

JUL 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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Page 21 of 51

EMSWORLD.com | JULY 2018 21 used by the general public. There were no statistically significant differences noted when comparing the CPR quality of police officers and the general public (all p-values > 0.05). Overall, the average chest compres- sion fraction was 76%, while the average depth was 5.3 cm and average compression rate was 111.2 per minute. Bystanders performed better when basing the assessment on the 2010 guidelines vs. the 2015 guidelines. When evaluating adher- ence to the 2010 guidelines, 66% adhered to the recommended rate of greater than 100 compressions per minute, 55% adhered to the recommended depth of greater than 5.0 cm, and 41% adhered to both the rec- ommended rate and depth. When assess- ing adherence to the 2015 guidelines, 50% adhered to the recommended compression rate of between 100–120/min., 29% adhered to the recommended compression depth of between 5–6 cm, and 16% adhered to both the rate and depth recommendations. Aver- age perishock pause was about 27 seconds. Interestingly, the authors found that for all measures of CPR quality as well as adher- ence to the 2010 and 2015 guidelines, per- formance was worse in the first minute of the resuscitation. This improved across the board in the second minute and remained consistent throughout the final four minutes of the evaluation period. The authors sug- gested this could be due to the program- ming of the AEDs: They noted the average time from turning on the AED to analyzing the rhythm was over 40 seconds, and the rhythm analysis took almost 10 seconds. Due to this finding, the authors recom- mended that AED manufacturers program their machines to prompt bystanders to immediately begin chest compressions and that artifact filtering technology be utilized to allow for rhythm analysis during compres- sions. They further postulated that deficien- cies in rate and depth of CPR could be due to difficulty estimating measurements and fear of causing harm. They noted this is likely alleviated after feedback is provided. Limitations Like every study, there are limitations here, and the authors describe them well. The most glaring is the exclusion of about 98% of the population of OHCA patients. This could introduce selection bias. Also, results may not be generalizable, particularly when compared to performance when CPR feed- back is not provided. Finally, there is no way to know the level of training or how many bystanders participated in the resuscitation. This was an interesting study with well- thought-out case definitions and appropriate statistical analyses. it found that bystand- ers who step up to intervene in OHCA can and, more often than not, do provide quality CPR. If you haven't found a way to promote bystander CPR in your area, hopefully this study provides motivation. ABOUT THE AUTHOR Antonio R. Fernandez, PhD, NRP, FAHA, is research director at the EMS Performance Improvement Center and an assistant professor in the Department of Emergency Medicine at the University of North CarolinaÐChapel Hill. PCRF SALUTES OUR SUPPORTING ORGANIZATIONS: Visit prehospitalcare.org to learn more and submit your abstract by August 31, 2018. Questions? E-mail pcrf@mednet.ucla.edu. Do you have EMS research to disseminate? Are you a student or EMS provider who is new to research and looking for feedback from leaders in the field? We are looking to develop the next generation of EMS researchers who will be par t of the evolution of EMS. Researchers who submit the top clinical abstracts receive a complimentar y registration to EMS World Expo in Nashville, TN October 29—November 2, will be invited to present their abstracts at the International Scientific Symposium and will have their abstracts published by EMS World. CALL FOR ABSTRACTS Using science to advance EMS practice Submit your research for the 2nd Annual INTERNATIONAL SCIENTIFIC EMS SYMPOSIUM, to be held at EMS World Expo 2018, facilitated by the Prehospital Care Research Forum at UCLA. AT

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