• Marek Małysz, Jacek Smereka, Miłosz Jaguszewski, Marek Dąbrowski, Klaudiusz Nadolny, Kurt Ruetzler, Jerzy R Ładny, Maciej Sterliński, Krzysztof J Filipiak, and Łukasz Szarpak.
• Kardiol Pol. 2020 Dec 23; 78 (12): 1254-1261.

BackgroundCardiopulmonary resuscitation with the use of personal protective equipment (PPE) for aerosol generating procedures (AGP) in patients with suspected or confirmed coronavirus disease 2019 (COVID‑19) remains challenging.AimsThe aim of this study was to compare 3 chest compression (CC) methods used by paramedics wearing PPE.MethodsThe single‑blinded, multicenter, randomized, crossover simulation study involved 67 paramedics wearing PPE AGP. They performed 2‑minute continuous CCs in an adult with suspected or confirmed COVID‑19 in 3 scenarios: 1) manual CCs; 2) CCs with the TrueCPR feedback device; 3) CCs with the LUCAS 3 mechanical CC device.ResultsThe depth of CC was more frequently correct when using LUCAS 3 compared with TrueCPR and manual CC (median [IQR] 51 [50-55] mm vs 47 [43-52] mm vs 43 [38-46] mm; P = 0.005). This was also true for the CC rate (median [IQR]102 [100-102] compressions per minute [CPM] vs 105 [98-1114] CPM vs 116 [112-129] CPM; P = 0.027) and chest recoil (median [IQR]100% [98%-100%] vs 83% [60%-92%] vs 39% [25%-50%]; P = 0.001). A detailed analysis of 2‑minute resuscitation with manual CCs showed a decrease in compression depth and full chest recoil after 1 minute of CCs.ConclusionWe demonstrated that during simulated resuscitation with the use of PPE AGP in patients with suspected or confirmed COVID‑19, CC with LUCAS 3 compared with manual CCs as well as the TrueCPR essentially increased the CC quality. In the case of manual CCs by paramedics dressed in PPE AGP, it is advisable to change the person performing resuscitation every minute.

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