Does delivering chest compressions to patients who are not in cardiac arrest cause unintentional injury? A systematic review
Background: Chest compressions are life-saving in cardiac arrest but concern by layperson of causing unintentional injury to patients who are not in cardiac arrest may limit provision and therefore delay initiation when required. Aim: To perform a systematic review of the evidence to identify if; am...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424002790 |
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| Summary: | Background: Chest compressions are life-saving in cardiac arrest but concern by layperson of causing unintentional injury to patients who are not in cardiac arrest may limit provision and therefore delay initiation when required. Aim: To perform a systematic review of the evidence to identify if; among patients not in cardiac arrest outside of a hospital, does provision of chest compressions from a layperson, compared to no use of chest compressions, worsen outcomes. Method: We searched Medline (Ovid), Web of Science Core Collection (clarivate) and Cinahl (Ebsco). Outcomes included survival with favourable neurological/functional outcome at discharge or 30 days; unintentional injury (e.g. rib fracture, bleeding); risk of injury (e.g. aspiration). ROBINS-I was used to assess for risk of bias. Grading of Recommendations, Assessment, Development and Evaluation methodology was used to determine the certainty of evidence. (PROSPERO registration number: CRD42023476764). Results: From 7832 screened references, five observational studies were included, totaling 1031 patients. No deaths directly attributable to chest compressions were reported, but 61 (6 %) died before discharge due to underlying conditions. In total, 9 (<1%) experienced injuries, including rib fractures and different internal bleedings, and 24 (2 %) reported symptoms such as chest pain. Evidence was of very low certainty due to risk of bias and imprecision. Conclusion: Patients initially receiving chest compressions by a layperson and who later were determined by health care professionals to not be in cardiac arrest rarely had injuries from chest compressions. |
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| ISSN: | 2666-5204 |