Quantitative effects of mechanical cardiopulmonary resuscitation devices in rural American emergency medical services: a retrospective cohort study
Dublin Core
Title
Quantitative effects of mechanical cardiopulmonary resuscitation devices in rural American emergency medical services: a retrospective cohort study
Subject
Mechanical CPR, Prehospital, Resuscitation, Cardiac arrest
Description
Abstract
Background Emergency medical service agencies increasingly utilize medical devices which perform external chest
compressions during cardiac arrest. Due to the unique staffing and budget considerations of the rural emergency
medical services environment, an investigation of mechanical cardiopulmonary resuscitation in this setting is
warranted. Studying the effects of new technologies in the rural environment promotes improvement of the standard
of rural prehospital care. This study evaluated the effect of mechanical cardiopulmonary resuscitation use on rural out-
of-hospital cardiac arrest performance measures.
Methods Five hundred eighty-five rural cardiac arrests were assessed from National Emergency Medical Services
Information System 2017–2019 data. Using both linear and logistic multivariate regression analysis, the effect
of mechanical cardiopulmonary resuscitation on the incidence of a return of spontaneous circulation, the first
defibrillation interval, and the first cardiac epinephrine administration interval was assessed.
Results In rural cardiac arrest with initial presentation of a shockable rhythm, the use of mechanical cardiopulmonary
resuscitation devices delayed initial defibrillation by 21.5% (p<0.05). A 15.1% (p<0.05) delay in first administration
of epinephrine was also found when mechanical cardiopulmonary resuscitation was used. Incidence of return of
spontaneous circulation was unchanged between manual and mechanical cardiopulmonary resuscitation conditions.
Conclusions Current rural mechanical cardiopulmonary resuscitation device use can have a negative effect
on prompt delivery of vital interventions. Our findings suggest that improvements to equipment training may
help remedy improper utilization of mechanical cardiopulmonary resuscitation devices. Delaying application of
mechanical cardiopulmonary resuscitation devices until time-sensitive interventions are complete may result in a
better standard of care. Proper use of mechanical cardiopulmonary resuscitation devices may help to overcome
inherent difficulties faced by rural prehospital clinicians.
Keywords Mechanical CPR, Prehospital, Resuscitation, Cardiac arrest
Background Emergency medical service agencies increasingly utilize medical devices which perform external chest
compressions during cardiac arrest. Due to the unique staffing and budget considerations of the rural emergency
medical services environment, an investigation of mechanical cardiopulmonary resuscitation in this setting is
warranted. Studying the effects of new technologies in the rural environment promotes improvement of the standard
of rural prehospital care. This study evaluated the effect of mechanical cardiopulmonary resuscitation use on rural out-
of-hospital cardiac arrest performance measures.
Methods Five hundred eighty-five rural cardiac arrests were assessed from National Emergency Medical Services
Information System 2017–2019 data. Using both linear and logistic multivariate regression analysis, the effect
of mechanical cardiopulmonary resuscitation on the incidence of a return of spontaneous circulation, the first
defibrillation interval, and the first cardiac epinephrine administration interval was assessed.
Results In rural cardiac arrest with initial presentation of a shockable rhythm, the use of mechanical cardiopulmonary
resuscitation devices delayed initial defibrillation by 21.5% (p<0.05). A 15.1% (p<0.05) delay in first administration
of epinephrine was also found when mechanical cardiopulmonary resuscitation was used. Incidence of return of
spontaneous circulation was unchanged between manual and mechanical cardiopulmonary resuscitation conditions.
Conclusions Current rural mechanical cardiopulmonary resuscitation device use can have a negative effect
on prompt delivery of vital interventions. Our findings suggest that improvements to equipment training may
help remedy improper utilization of mechanical cardiopulmonary resuscitation devices. Delaying application of
mechanical cardiopulmonary resuscitation devices until time-sensitive interventions are complete may result in a
better standard of care. Proper use of mechanical cardiopulmonary resuscitation devices may help to overcome
inherent difficulties faced by rural prehospital clinicians.
Keywords Mechanical CPR, Prehospital, Resuscitation, Cardiac arrest
Creator
Peter H. King1
and Esmaeil Bahalkeh2*
and Esmaeil Bahalkeh2*
Date
2025
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Peter H. King1
and Esmaeil Bahalkeh2*, “Quantitative effects of mechanical cardiopulmonary resuscitation devices in rural American emergency medical services: a retrospective cohort study,” Repository Horizon University Indonesia, accessed April 14, 2026, https://repository.horizon.ac.id/items/show/13220.