Quality of closed chest compression in ambulance vehicles, flying helicopters and at the scene.

CONTEXT: Transport of patients during resuscitation is a critical procedure. In both, ambulances and helicopters the quality of resuscitation is potentially hampered due to the movement of the vehicle and confined space. To date, however, no direct comparison of the quality of resuscitation at the scene, during a helicopter flight and in a moving ambulance has been made.

OBJECTIVE: Direct comparison of the quality of resuscitation at the scene, during a helicopter flight and in a moving ambulance.

DESIGN: The study was performed in July 2005 as a randomised cross-over trial comparing different environments for resuscitation.

SETTING: Medical University of Vienna.

PARTICIPANTS: Eleven European Resuscitation Council (ERC) approved health care professionals.

INTERVENTIONS: Interventions during resuscitation: (a) in a moving ambulance, (b) in a flying helicopter, were compared to those staying at the (c) scene (control). Each participant performed resuscitation in all three environments.

MAIN OUTCOME MEASURES: Quality of chest compression during resuscitation.

RESULTS: Compared to resuscitation at the scene, efficiency of chest compressions during a helicopter flight was 86% and 95% in the moving ambulance 95%. There were no differences in secondary outcomes (time without chest compression, total number of incorrect hand position relative to total compressions, and total number of incorrect pressure release relative to total compressions).

CONCLUSIONS: Resuscitation during transport is feasible and relatively efficient. There is some difference between the environments, but there is no relevant difference between helicopters and ambulances regarding the effectiveness of CPR.