Does the use of Bariboard(TM) improve adequacy of chest compressions in morbid obesity?

Status

Completed

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12619000011189

Enrollment

205

Registered

2019-01-08

Start date

2019-02-13

Completion date

2019-08-21

Last updated

2020-02-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

There is little research regarding the efficacy of CPR in obese patients. Using a simulation model we have previously demonstrated that the adequacy of chest compressions in morbidly obese mannequins is compromised, predominantly in the domains of achieving adequate compression depth and allowing sufficient time for chest wall recoil during CPR. The Bariboard(TM) is a device that purports to aid in the redistribution of forces applied to the anterior chest wall in order to improve the adequacy of chest compression. There have been no empirical trials using this device. Aim of Study: The primary aim of this study will be to explore whether the adequacy of chest compressions can be improved using a mechanical device (Bariboard(TM)) to better distribute the mechanical forces applied to the anterior thorax during CPR. Primary outcome: * To measure the efficacy of chest compressions using a previously described model of morbid obesity with and without a mechanical device that raises the thoracic cage. This will use the digital mannequins to record the quality and adequacy of chest compressions over a period of 2 minutes of uninterrupted CPR. Effective CPR will be defined as a composite measure of adequate depth of compression, adequate time for recoil at an adequate rate for >90% of compressions delivered. Secondary outcomes: * Adequacy of each component of CPR (namely rate, depth of compressions and adequate recoil). * Time taken for participants to fatigue when performing CPR on a morbidly obese mannequin. It is known that the maximum amount of time a member of staff can perform effective CPR is 2 minutes in a normal scenario. * Participant discomfort/pain experienced during CPR. * The association between staffs' perceived effectiveness and the recorded adequacy of chest compressions.

Interventions

Randomised, blinded cross over design The intervention arm will be asked to perform two minutes of uninterrupted CPR on a mannequin that has been encased in a suit containing pig fat in a vacuum sealed bag to a depth that mimics a BMI of 40kg/m2, with the Bariboard(TM) device in use. The Bariboard(TM) is a piece of equipment that is placed under the supine bariatric patient during CPR, which has been designed to better support the the spine and torso as it is contoured with the larger patient in mind. The additional support to the spine and thorax aims to decrease patient's posterior surface area and change force distribution during CPR, increasing the effectiveness of chest compressions delivered by the rescuer. CPR will be uninterrupted compressions, at participants discretion (i.e. without prompting from examiners), although revision of the elements of adequate compressions as per standard Australian BLS guidelines (ANZCOR) with the participants will occur just prior to completing the station. Blinding will occur by concealing the device within the sheeting of the bed on which the mannequin lies. There will be a washout period between each arm of 5 minutes to allow participant recovery.

Study design

Allocation

Randomised controlled trial

Intervention model

Crossover

Primary purpose

Treatment

Masking

Blinded (masking used) (Caregiver)

Eligibility

Sex/Gender

All

Age

18 Years to 65 Years

Healthy volunteers

Yes

Inclusion criteria

Health care staff who have previously undergone BLS training and would be expected to provide CPR during cardiopulmonary arrest.

Exclusion criteria

Untrained in BLS Unable to undertake 2 minutes of CPR Currently undergoing a managed return to work program

Outcome results