• Lukasz Szarpak, Zenon Truszewski, Lukasz Czyzewski, Michael Frass, and Oliver Robak.
• Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
• Am J Emerg Med. 2017 Jan 1; 35 (1): 96-100.

IntroductionEuropean Resuscitation Council as well as American Heart Association guidelines for cardiopulmonary resuscitation (CPR) stress the importance of uninterrupted and effective chest compressions (CCs). Manual CPR decreases in quality of CCs over time because of fatigue which impacts outcome. We report the first study with the Lifeline ARM automated CC device for providing uninterrupted CCs.MethodsSeventy-eight paramedics participated in this randomized, crossover, manikin trial. We compared the fraction of effective CCs between manual CPR and automated CPR using the ARM.ResultsUsing the ARM during resuscitation resulted in a higher percentage of effective CCs (100/min [interquartile range, 99-100]) compared with manual CCs (43/min [interquartile range, 39-46]; P<.001). The number of effective CCs decreased less over time with the ARM (P<.001), more often reached the required depth of 5 cm (97% vs 63%, P<.001), and more often reached the recommended CC rate (P<.001). The median tidal volume was higher and hands-off time was lower when using the ARM.ConclusionMechanical CCs in our study adhere more closely to current guidelines than manual CCs. The Lifeline ARM provides more effective CCs, more ventilation time and minute volume, less hands-off time, and less decrease in effective CCs over time compared with manual Basic Life Support and might therefore impact outcome.Copyright © 2016 Elsevier Inc. All rights reserved.

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