Another alternative to accelerometers is the use of electro-magnetic signals to measure the chest displacement. However, all of the aforementioned solutions increase the complexity of the feedback device. Other reference signals correlated with the displacement such as the force, the blood pressure, or the transthoracic impedance could also improve depth calculations. Increased accuracy could be achieved with a chest compression artefact detector on an additional ECG channel. Some devices include additional force/pressure sensors to identify these points. A strategy to solve this problem consists in fixing adequate boundary conditions at the onset/offset of each compression. However, integration is a process inherently unstable: the accumulation of integration errors with time results in a significant drift in displacement that impedes accurate estimation of the compression depth. Inbuilt processors integrate the acceleration numerically using algorithms such as the trapezoidal rule. More recent devices are based on accelerometers, and calculate the compression depth from the double integration of the acceleration of the chest during CPR. However, differences in chest stiffness among individuals and during the course of the resuscitation attempt proved this assumption erroneous in humans. The first CPR devices were based on pressure/force sensors, assuming a linear relation between the applied force and the achieved compression depth. In the last decade several feedback systems have been developed, and there is evidence of their contribution to improve adherence to recommendations for high-quality CPR during training and in the clinical practice. ![]() This suggested the need for new strategies to improve CPR quality, such as feedback devices for real-time monitoring and to provide assistance to rescuers, and also for a posteriori debriefing sessions. However, studies showed that even trained rescuers often provided too slow and too shallow chest compressions with many interruptions both in hospital and out of hospital. Ĭurrent resuscitation guidelines emphasize the importance of providing high quality chest compressions, that is, with a depth of at least 5 cm (but no more than 6 cm) and a rate of between 100 and 120 compressions per minute, allowing chest recoil between compressions and minimizing interruptions. Survival of ventricular fibrillation cardiac arrest can be doubled or tripled by performing CPR. CPR involves chest compressions that maintain a small critical blood flow to the brain and the myocardium, and increases the likelihood of a successful defibrillation. CPR and defibrillation are the fundamental components of the chain. These actions are represented by the chain of survival, which consists of four links: early recognition of the emergency, early bystander cardiopulmonary resuscitation (CPR), early defibrillation, and early access to advanced care. The International Liaison Committee on Resuscitation (ILCOR) establishes the actions that should be conducted to treat patients in cardiac arrest. In North America and Europe, death from sudden cardiac arrest has an incidence of about 50 to 100 population every year, and survival to hospital discharge is poor (less than 10% on average). Sudden cardiac arrest is defined as the sudden cessation of the mechanical activity of the heart, confirmed by the absence of signs of circulation. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors. There are no further patents, products in development or marketed products to declare. Authors JMR, DMGO and SRDG declare the patent application number EP 2883496 A1 “Device and method for cardiac resuscitation”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: Author JKR declares no competing interests. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: This work was supported by Ministerio de Economía y Competitividad: TEC2012-31144 (, SRDG JR DMGO) and Basque Government (Gobierno Vasco): BFI-2011-166 (, DMGO). ![]() Received: SeptemAccepted: FebruPublished: March 1, 2016Ĭopyright: © 2016 Ruiz de Gauna et al. Citation: Ruiz de Gauna S, González-Otero DM, Ruiz J, Russell JK (2016) Feedback on the Rate and Depth of Chest Compressions during Cardiopulmonary Resuscitation Using Only Accelerometers.
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