Effect of Acute Exposure to Altitude on the Quality of Chest Compression‐Only Cardiopulmonary Resuscitation in Helicopter Emergency Medical Services Personnel: A Randomized, Controlled, Single‐Blind Crossover Trial

URN to cite this document:

urn:nbn:de:bvb:355-epub-553558 Copy

DOI to cite this document:

10.5283/epub.55355 Copy

Vögele, Anna ; van Veelen, Michiel Jan ; Dal Cappello, Tomas ; Falla, Marika ; Nicoletto, Giada ; Dejaco, Alexander ; Palma, Martin ; Hüfner, Katharina ; Brugger, Hermann ; Strapazzon, Giacomo

License: Creative Commons Attribution Non-commercial No Derivatives 4.0 PDF - Published Version (962kB)

Date of publication of this fulltext: 06 Feb 2024 12:16

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Details

Item type:	Article
Open Access Type:	CC-License
Journal or Publication Title:	Journal of the American Heart Association
Publisher:	Wiley
Place of Publication:	HOBOKEN
Volume:	10
Number of Issue or Book Chapter:	23
Date:	2 December 2021
Institutions:	Medicine > Lehrstuhl für Anästhesiologie
Identification Number:	Value Type 10.1161/JAHA.121.021090 DOI
Keywords:	RESCUER FATIGUE; LIFE-SUPPORT; GUIDELINES; DEPTH; CPR; cardiac arrest; chest compression; helicopter emergency medical services; hypobaric hypoxia; resuscitation
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Partially
Item ID:	55355

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Abstract

BACKGROUND: Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)-CPR after acute exposure to altitude under repeatable and standardized conditions. METHODS AND RESULTS: ...

Abstract

BACKGROUND: Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)-CPR after acute exposure to altitude under repeatable and standardized conditions. METHODS AND RESULTS: Forty-eight helicopter emergency medical services personnel were divided into 12 groups of 4 participants; each group was assigned to perform 5 minutes of CCO-CPR on manikins at 2 of 3 altitudes in a randomized controlled single-blind crossover design (200, 3000, and 5000 m) in a hypobaric chamber. Physiological parameters were continuously monitored; participants rated their performance and effort on visual analog scales. Generalized estimating equations were performed for variables of CPR quality (depth, rate, recoil, and effective chest compressions) and effects of time, altitude, carryover, altitude sequence, sex, qualification, weight, preacclimatization, and interactions were analyzed. Our trial showed a time-dependent decrease in chest compression depth (P=0.036) after 20 minutes at altitude; chest compression depth was below the recommended minimum of 50 mm after 60 to 90 seconds (49 [95% CI, 46-52] mm) of CCO-CPR. CONCLUSIONS: This trial showed a time-dependent decrease in CCO--CPR quality provided by helicopter emergency medical services personnel during acute exposure to altitude, which was not perceived by the providers. Our findings suggest a reevaluation of the CPR guidelines for providers practicing at altitudes of 3000 m and higher. Mechanical CPR devices could be of help in overcoming CCO-CPR quality decrease in helicopter emergency medical services missions.

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Metadata last modified: 06 Feb 2024 16:28

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