Does CPR on a moving stretcher work?

NEW YORK (Reuters Health) - Paging script-writers: Pumping on a patient’s chest during CPR while a stretcher careens down a hospital hallway works just fine, Chinese researchers have found.

By straddling patients on the stretcher -- think “ER,” the American TV drama -- paramedics can get them faster to and from the ambulance while still doing cardiopulmonary resuscitation (CPR).

What hadn’t been clear was how that precarious position would affect the quality of chest compression done by people without the balance of a bull rider.

So the researchers, led by Dr. Zhou Yaxiong at West China Hospital of Sichuan University in Chengdu, had 20 medical students do chest compressions on a resuscitation dummy that measured the quality of their work. They would do compressions for one minute, both on the floor and on a moving stretcher.

When the researchers examined the data from the dummy, they found no difference in compression rate, depth or efficacy between the two positions. However, the students were able to start CPR about seven seconds earlier when they didn’t have to mount the stretcher, and they said it was comfortable sitting on the floor.

In the report, the researchers thank the students for their “enthusiastic collaboration” and note that none of them fell off the stretcher.

In clinical terms: “Paramedics do not necessarily need to stop transporting the victims while external chest compression is in progress but can perform straddling external chest compression on a moving stretcher instead,” they write in the journal Resuscitation.

“By doing so, time for transporting victims to the emergency department to get advanced life support may be shortened.”

Dr. Dana Edelson, associate chair of the CPR Committee at the University of Chicago, said the results were surprising.

“It goes against conventional wisdom that moving on a stretcher you would do CPR of the same quality as when you are on the floor,” she told Reuters Health, adding that more research was needed to confirm the findings.

She stressed that it wasn’t clear at this point that getting to the hospital sooner meant a better outcome. And the larger size of most Americans compared with Chinese might also make straddling patients a tougher job in the U.S.

“The general recommendation is still as far as possible to continue doing CPR at the scene and focus on doing the best CPR you can muster,” she said.

In case you were wondering: Doing CPR while walking alongside a moving stretcher, instead of straddling the patient, doesn’t work as well, according to previous studies.

It appears that mouth-to-mouth resuscitation - shown to be of limited value in another study last week - while straddling dummies on a moving stretcher has not yet been studied.

SOURCE: Resuscitation, July 20, 2010.