Poster Presentations / Resuscitation 84S (2013) S8–S98 S27

p < 0.001). Good-quality BCPR was less frequently performed byfamily members (216/459 vs. 79/118, p < 0.001), elderly bystander(60/447 vs. 32/111, p < 0.0001) and in OHCAs at home (233/459 vs.86/118, p < 0.0001). Multiple logistic regression analysis disclosedthat the central region (odds ratio = 2.010, 95% CI: = 1.298–3.146),non-elderly bystander (6.098, 1.534–30.303), multiple rescuers(2.256, 1.291–4.159), and BCPR on bystander’s initiative (3.022,1.324–8.172) were independent factors associated with good-quality BCPR. Good-quality BCPR was initiated earlier after arrestrecognition/witness than poor-quality BCPR (p = 0.005). The rate ofsurvival at one-year with cerebral performance category ≥ 2 was2.8% (13/459) in good-quality group and 0% (0/118) in poor-qualitygroup. However, the rate did not significantly differed between twogroups (p = 0.064).

Conclusions: The presences of multiple rescuers, non-elderlybystander and BCPR on bystander’s own initiative are associatedwith good-quality BCPR. Further investigation is necessary to elu-cidate the effect of the quality of BCPR on outcomes of OHCAs.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.079

AP048

Chest compression quality declines in theminutes preceding scene departure inout-of-hospital cardiac arrest

Annemarie Silver 1,∗, Tyler Vadeboncoeur 2, MarkVenuti 3, John Tobin 4, Gary Smith 4, MargaretMullins 5, Daniel Spaite 5, Bentley Bobrow 6

1 ZOLL Medical Corporation, Chelmsford, MA, USA2 Mayo Clinic Florida, Jacksonville, FL, USA3 Guardian Medical Transport, Flagstaff, AZ, USA4 Mesa Fire/Medical Department, Mesa, AZ, USA5 University of Arizona, Tucson, AZ, USA6 Maricopa Medical Center, Phoenix, AZ, USA

Purpose of the study: Previous studies have shown that chestcompression (CC) quality declines during ambulance transport.However, the quality of CCs while preparing a patient for transportand transferring to the ambulance has not been described in theclinical setting. We tested the hypothesis that CC quality diminishesduring the transition from the scene to the ambulance.

Materials and methods: CC quality was monitored at two EMSagencies using an E Series defibrillator with CC sensing capability(ZOLL Medical) during the treatment of consecutive out-of-hospitalcardiac arrest patients who received CC on scene and were trans-ported to the ED with on-going CC. Minute-by-minute CC processdata were averaged for all minutes without ROSC during late scenetreatment (i.e. 3 min prior to transport) and early scene treatment(i.e. all prior minutes at scene). Paired t-tests were used to compareCC quality during late scene vs. early scene treatment.

Results: A total of 211 cardiac arrest events requiring CPR at thetime of scene departure were studied (mean age 64 years, 67% male,8% survival to discharge). CC fraction, rate, and percent of compres-sions > 2 in. were significantly reduced during late vs. early scene

Table 1

Early scene Late scene p-Value

Mean CC fraction (%) 74 ± 16 61 ± 23 <0.001Mean depth (in.) 1.92 ± 0.47 1.87 ± 0.45 0.11Mean rate (in.) 108 ± 15 103 ± 20 <0.001Release velocity(in./s) 12.02 ± 2.82 11.96 ± 3.01 0.8SD depth (in.) 0.18 ± 0.06 0.30 ± 0.14 <0.001SD rate 13 ± 5 23 ± 9 <0.001CC > 2 in. (%) 53 ± 33 45 ± 32 <0.001

treatment and variability in depth and rate (standard deviation)were increased during late scene treatment (Table 1).

Conclusion: CC quality declines in the minutes preceding trans-port, presumably because of the difficulty of performing highquality CCs while preparing the patient for transport and movingthe patient to the ambulance. The impact of this finding on outcomerequires further study.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.080

AP049

“Great quality” CPR implementation (2010 ERCguidelines). The importance of refreshingtrainings

Manel Cerdà ∗, Xavier Balanzó, Francesc Carmona,Miquel Arbós, Salvador Quintana

Catalan Ressuscitation Council, Catalonia, Spain

Purpose: To analyze how 2010 guidelines have been incor-porated to practice and if there is any relationship between CPRquality and the number of performed courses or the time past fromthe last course.

Methods: 64 participants were randomly selected from a pool ofEmergency Medical Technicians who yearly performed CPR coursesand gave their consent to participate. They were invited to per-form 2 min of CPR and the results were registered by Laerdal PCSkill Reporting System v4.2.1. The studied variables were age, sex,number of CPR courses performed, date of the last course and qual-ity of CPR. Quality of CPR was defined as the mean score of handsplacement and chest compressions depth, rate and thorax decom-pression.

Qualitative data has been expressed as percents, quantitativedata as mean and standard deviation (SD). Multivariate analysis hasbeen performed using lineal multiple regression. A p value under0.05 was considered significant.

Results: From 64 participants, 78% were males, the mean agewas 38 (SD = 6), the mean of performed courses was 5.5 (SD = 1.2)with a mean of 8 months (SD = 5) from the last course. The meanscore given by the software was 54 (SD = 20): 40 (SD = 40) for chestcompressions rate, 55 (SD = 42) for depth, 81 (SD = 30) for handsplacement and 92 (SD = 19) for decompression.

After adjusting by age and sex, no significant relation was foundin the lineal multiple regression between the number of performedcourses or the time past from the last course and the quality of CPR.

Conclusions: After 18 months of their publication, 2010 guide-lines have not still been incorporated to practice, as chestcompressions rate (too high) and depth (too weak) are not the rec-ommended. There’s no relation between the number of courses orthe time past from the last course and the quality of CPR.

http://dx.doi.org/10.1016/j.resuscitation.2013.08.081

AP050

Out-of-hospital cardiac arrest—Does bystanderCPR and EMS personell qualification improveoutcome?

Anita Kaleja ∗, Elina Snucina, Indulis Vanags

Pauls Stradins University Hospital, Riga, Latvia

Purpose of the study: To evaluate survival rate among patientswith out-of-hospital cardiac arrest.

Materials and methods: There were 451 adult patients without-of-hospital cardiac arrest included in a retrospective study dur-