Effect of safety belts on chest compression quality in a moving ambulance

Objective: This study aimed to examine the effect of specially designed safety belts on standard cardiopulmonary resuscitation (CPR) quality in a manikin and to determine whether straddle (STR) CPR is equivalent to standard CPR in a moving ambulance. Methods: Thirty-five emergency medical technicians were recruited and divided into two groups. The first group subjects were randomly assigned to perform standard CPR with or without safety belts. The second group subjects wore safety belts and were randomly assigned to perform STR or standard CPR. Chest compression quality was evaluated by measuring the average rate, depth of compressions, the hands off time and incorrect hand position. Results: The compression rate was significantly higher in the safety belt group (114.0/min vs. 106.5/min, p=0.001), but the compression depth was not significantly different. The hands-off time was also shorter in the safety belt group (24.5 seconds vs. 40 seconds, p=0.003). When STR CPR was performed, the compression depth was significantly deeper (42 mm vs. 36 mm, p=0.004), and the hands off time was shorter (6 seconds vs. 10 seconds, p=0.039) than with standard CPR. A follow-up questionnaire revealed that 65.7% of the respondents had stopped CPR in the past due to safety reasons, and 48.6% had been injured during CPR. Conclusions: Wearing belts in a moving ambulance situation can increase the quality of CPR. If an appropriate belt can be designed, the STR method may be used effectively.