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Evaluation of the quality of cardiopulmonary resuscitation according to vehicle driving pattern, using a virtual reality ambulance driving system: a prospective, cross-over, randomised study

 Jin Ho Beom  ;  Min Joung Kim  ;  Je Sung You  ;  Hye Sun Lee  ;  Ji Hoon Kim  ;  Yoo Seok Park  ;  Dong Min Shin  ;  Hyun Soo Chung 
 BMJ OPEN, Vol.8(9) : e023784, 2018 
Journal Title
Issue Date
chest compression parameters ; emergency medical services ; virtual reality simulator

To analyse changes in the quality of cardiopulmonary resuscitation (CPR) according to driving patterns encountered during ambulance transport, using a virtual reality simulator.


Prospective, cross-over, randomised study.


This study was conducted at the National Fire Service Academy, Cheonan-si, Korea.


Emergency medical technicians (39 men and 9 women) attending the National Fire Service Academy for clinical training with ≥6 months field experience or having performed ≥10 CPR. Individuals who withdrew consent were excluded.


CPR quality parameters (eg, chest compression depth and its variability).


Chest compressions were performed for 8 min each in a stationary and driving state. The mean chest compression depths were 54.8 mm and 55.3 mm during these two states, respectively (p=0.41). The SD of the chest compression depth was significantly higher while in the driving (7.6 mm) than in the stationary state (6.5 mm; p=0.04). The compression depths in the speed bump and sudden stop sections were 51.5 mm and 50.6 mm, respectively, which was shallower than those in all other sections (p<0.001). The correct hand position rate was low in the speed bump, sudden stop and right-hand cornering sections (65.4%, 71.5% and 72.5%, respectively; p=0.001) CONCLUSIONS: Although we found no differences in chest compression quality parameters between the stationary and driving states, the variability in the chest compression depth increased in the driving state. When comparing CPR quality parameters according to driving patterns, we noted a shallower compression depth, increased variability and decreased correct hand position rate in the speed bump, sudden stop and right-hand cornering sections. The clinical significance of these changes in CPR quality during ambulance transport remains to be determined. Future studies on how to reduce changes in the quality of CPR (including research on equipment development) are needed.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Kim, Ji Hoon(김지훈) ORCID logo https://orcid.org/0000-0002-0070-9568
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Beom, Jin Ho(범진호) ORCID logo https://orcid.org/0000-0002-2805-257X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Hyun Soo(정현수) ORCID logo https://orcid.org/0000-0001-6110-1495
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