Relationship between Age and Outcomes of Patients Receiving Manual versus Mechanical Chest Compressions
Dr. Emilie Dykstra Goris, PhD, RN, Hope College Department of Nursing, Stephanie Mullennix, BSN, RN, CEN, Spectrum Health
Cardiopulmonary resuscitation (CPR) is typically performed as treatment for patients presenting with cardiac arrest. Recent advances in medical technology have introduced the use of mechanical chest compression devices, such as the LUCAS 2, which may lead to improved quality of compressions in circumstances requiring prolonged CPR. The purpose of this quality improvement project was to examine the relationship between age and the outcomes of patients receiving manual versus mechanical chest compressions in the emergency department. Jean Watson’s Theory of Caring addresses problem solving and decision making as important components of caring for patients and was used to shape this study. A retrospective chart review of 62 patients who presented with cardiac arrest in the emergency department of a Magnet designated hospital in the Midwest compared patients receiving mechanical CPR (45.2%, n=28) to patients receiving manual CPR (54.8%, n=34). Binary logistic regression analyses were performed to predict outcomes (return of spontaneous circulation) based on age for patients who received mechanical or manual CPR using SPSS version 23. 25.0% (n=7) of patients receiving mechanical chest compressions achieved return of spontaneous circulation compared to 58.8% (n=20) of patients receiving manual chest compressions. Age contributed significantly to prediction of the outcome of patients who received mechanical chest compressions (p=.038), but not for patients who received manual chest compressions (p=.092). Because age is a significant predictor of the outcome of patients who receive mechanical chest compressions, it should be considered when deciding on device implementation. Limitations include a convenience sample from a single site and some incomplete data. In addition to the American Heart Association guidelines, with increased knowledge about the LUCAS 2 device and patient outcomes, nurses can advocate for appropriate use of the device to ensure that patients are receiving high quality care.
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