, Volume 29, Issue 12, pp 2330-2335

Do different mattresses affect the quality of cardiopulmonary resuscitation?

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Abstract

Objective

To determine the effect of different mattresses on cardiopulmonary resuscitation performance and establish whether emergency deflation of an inflatable mattress improves the quality of resuscitation.

Design and setting

Randomised controlled cross-over trial performed in a general ICU

Participants

Critical care staff from a general ICU.

Interventions

Cardiopulmonary resuscitation on a manikin on the floor or on a bed with a standard foam mattress and inflated and deflated pressure redistributing mattresses. Maximal compression force was measured at different bed heights.

Measurements and results

Compression depth, duty cycle and rate and percentage correct expired air ventilation were recorded on a manikin. Compression depth was significantly lower on the foam (35.2 mm), inflated (37.2 mm) and deflated mattress (39.1 mm) than the floor (44.2 mm). There were no clinically important differences in duty cycle or compression rate. The quality of ventilation was poor on all surfaces. Maximal compression force declined as bed height increased.

Conclusions

Resuscitation performance is adversely affected when performed on a bed (irrespective of mattress type) compared to the floor. There were no differences between the inflated and deflated mattresses, although the deflation process did not adversely affect performance. This study does not support the routine deflation of an inflated mattress during resuscitation and questions the potential benefits from using a backboard. The finding that bed height affects maximal compression forces, challenges the recommendation that cardiopulmonary resuscitation be performed with the bed at middle-thigh level and requires further investigation.

Dr. Robert Benny was tragically killed in a road accident during the Summer of 2003. Dr. Benny was at the very start of a promising career in surgery. Our thoughts go to his family and friends.
G.D.P. and M.T. have received travelling fellowships from Huntleigh Healthcare, and M.T. has previously delivered lectures for Huntleigh Healthcare.