King Peter H, Bahalkeh Esmaeil
Biomedical Science, College of Life Sciences and Agriculture, University of New Hampshire, Rudman Hall, 46 College Road G05, Durham, NH, 03824, USA.
Health Management and Policy, College of Health and Human Services, University of New Hampshire, Hewitt Hall, 4 Library Way 321, Durham, NH, 03824, USA.
Int J Emerg Med. 2025 Aug 11;18(1):151. doi: 10.1186/s12245-025-00920-5.
Emergency medical service agencies increasingly utilize medical devices which perform external chest compressions during cardiac arrest. Due to the unique staffing and budget considerations of the rural emergency medical services environment, an investigation of mechanical cardiopulmonary resuscitation in this setting is warranted. Studying the effects of new technologies in the rural environment promotes improvement of the standard of rural prehospital care. This study evaluated the effect of mechanical cardiopulmonary resuscitation use on rural out-of-hospital cardiac arrest performance measures.
Five hundred eighty-five rural cardiac arrests were assessed from National Emergency Medical Services Information System 2017-2019 data. Using both linear and logistic multivariate regression analysis, the effect of mechanical cardiopulmonary resuscitation on the incidence of a return of spontaneous circulation, the first defibrillation interval, and the first cardiac epinephrine administration interval was assessed.
In rural cardiac arrest with initial presentation of a shockable rhythm, the use of mechanical cardiopulmonary resuscitation devices delayed initial defibrillation by 21.5% (p < 0.05). A 15.1% (p < 0.05) delay in first administration of epinephrine was also found when mechanical cardiopulmonary resuscitation was used. Incidence of return of spontaneous circulation was unchanged between manual and mechanical cardiopulmonary resuscitation conditions.
Current rural mechanical cardiopulmonary resuscitation device use can have a negative effect on prompt delivery of vital interventions. Our findings suggest that improvements to equipment training may help remedy improper utilization of mechanical cardiopulmonary resuscitation devices. Delaying application of mechanical cardiopulmonary resuscitation devices until time-sensitive interventions are complete may result in a better standard of care. Proper use of mechanical cardiopulmonary resuscitation devices may help to overcome inherent difficulties faced by rural prehospital clinicians.
紧急医疗服务机构越来越多地使用在心脏骤停期间进行胸外按压的医疗设备。鉴于农村紧急医疗服务环境独特的人员配备和预算考量，有必要对这种情况下的机械心肺复苏进行调查。研究农村环境中新技术的效果有助于提高农村院前护理水平。本研究评估了使用机械心肺复苏对农村院外心脏骤停绩效指标的影响。
从国家紧急医疗服务信息系统2017 - 2019年数据中评估了585例农村心脏骤停病例。通过线性和逻辑多变量回归分析，评估了机械心肺复苏对自主循环恢复发生率、首次除颤间隔时间和首次使用心脏肾上腺素给药间隔时间的影响。
在最初表现为可电击心律的农村心脏骤停病例中，使用机械心肺复苏设备使首次除颤延迟了21.5%（p < 0.05）。使用机械心肺复苏时，首次使用肾上腺素的时间也延迟了15.1%（p < 0.05）。手动和机械心肺复苏情况下自主循环恢复的发生率没有变化。
目前农村使用机械心肺复苏设备可能会对关键干预措施的及时实施产生负面影响。我们的研究结果表明，改进设备培训可能有助于纠正机械心肺复苏设备的不当使用。在对时间敏感的干预措施完成后再延迟应用机械心肺复苏设备可能会带来更好的护理标准。正确使用机械心肺复苏设备可能有助于克服农村院前临床医生面临的固有困难。
