The study “The optimal surface for delivery of CPR: An updated systematic review and meta-analysis” aimed to determine the effect of different CPR delivery surfaces on patient outcomes and CPR quality. The review included manikin studies due to a lack of human studies and updated previous evaluations by the International Liaison Committee on Resuscitation (ILCOR). The analysis incorporated six new studies published since 2019, alongside eleven from the 2020 ILCOR review, with evidence certainty rated as low.
The study found that interventions such as using a backboard or placing the patient on the floor had minimal impact on achieving greater chest compression depth. Specifically, meta-analyses indicated that using a backboard led to a small 2mm increase in chest compression depth, while the use of a firm mattress or transitioning to the floor showed no significant difference.
The review highlighted the challenges of performing effective chest compressions on soft surfaces like mattresses, which can absorb up to 57% of the compression force, leading to insufficient depth and increased rescuer fatigue. The evidence remains of low certainty, primarily due to the indirectness of using manikin studies rather than clinical trials.
The study concludes that while current interventions show limited effectiveness in improving CPR quality, further research should focus on clinical outcomes and the logistical aspects of moving patients to firm surfaces during resuscitation.
Read the full article by Holt et al. (2024): https://doi.org/10.1016/j.resplu.2024.100718
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