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EWMA 2014 - EP441 CARDIOPULMONARY RESUSCITATION (CPR) -FUNCTION OF AIR MATTRESSES IS USELESS? - A MANIKIN STUDY
1. Cardiopulmonary resuscitation (CPR)
-function of air mattresses is
useless? - A manikin study
Esa Soppi1, Ansa Iivanainen2, Leila Sikanen2,
Elina Jouppila-Kupiainen2
1 Carital Group, Helsinki, Finland, 2 Mikkeli
University of Applied Science, Mikkeli, Finland
2. Introduction
• Patients in intensive care units (ICU) are severely ill and
therefore both susceptible for development of pressure
ulcers and acute cardiopulmonary resuscitation (CPR).
• A part of continuously functioning air mattresses are so
called open systems which are required to become deflated
at the initiation of CPR according to manufacturers’
instructions, while others are closed systems not
necessarily requiring deflation. Still air mattresses in acute
care units are expected to be equipped with CPR control
system to able a rapid deflation of the air mattress to allow
normal resuscitation procedures to be carried out.
• We examined whether this is really true. 2
3. Materials and methods
• Performance of higher specification foam mattress and
two dynamic air mattresses which modes of function are
totally different (Carital® Optima), closed system,
optimally adjusting to optimum irrespective of patient’s
weight, body shape, and position by the intelligent control
unit) and Nimbus® 3, alternating system, pump
functioning 24/7 making it an open system) during the
experimental resuscitation.
• A patient simulator manikin (SimMan 3G), was used as a
resuscitation target.
• All mattresses were on hard floor and a pressure sensitive
mat was placed between the mattress and manikin. 3
4. Results
Flat hard
floor
A higher
specification
foam
mattress
Carital®
Optima
Carital ®
Optima
with CRP
opened
Nimbus® 3
comfort
soft,
alternating
mode
Nimbus® 3
soft comfort,
alternating
mode with
CPR opened
Compression
frequency
/min (SD)
120.7
(11.3)
109.9
(8.3)
109.3
(8.6)
108.0
(5.1)
106.4
(9.9)
104.6
(5.6)
Compression
depth, mm
(SD)
45,8
(5.3)
43.4
(8.3)
45.5
(6.9)
41.6
(10.5)
47.5
(7.1)
47.0
(5.8)
Hands-on
time % at
120s (SD)
96.4
(0.9)
96.6
(0.5)
96.0
(1.1)
95.8
(1.1)
71.3
(14.8)
70.5
(7.7)
Stability,
VAS mm
(SD)
100
(-)
82.7
(10.2)
71.2
(18.7)
65.5
(19.1)
40.2
(24.1)
71.3
(20.2) 4
5. Conclusions
• No significant differences in compression frequency or depth
between surfaces were found indicating that the efficiency of CPR
seems to be adequate irrespective of the air mattress or whether CPR
function was in use or not.
• The stability of resuscitation procedure on Nimbus® 3 was less than
with the foam or Carital® Optima air mattress.
• In open mattress systems deflation of the mattress seem, however, to
improve the stability of resuscitation, when the height of the air
mattress is more than 20-25 cm.
• CPR with Carital mattress (closed air system) without opening the
CPR valve produces an optimal combination with respect to effort,
stability and effectiveness.
• Use of the CPR function i.e. making Carital an open system, worsens
its performance in resuscitation. 5