Hands-on or Hands-off: Manual versus Mechanical Chest Compressions
Chest compressions are initiated when electrical malfunctions cause the heart to stop. Two methods of restoring circulation may be used when someone’s heart stops: manual chest compressions (Man-CPR) or mechanical chest compressions (Mech-CPR); however, the ability of these methods to achieve ROSC (return of spontaneous circulation) in a timely manner varies between the two methodologies. Man-CPR, for the purpose of this review, is defined as the use of someone’s physical strength to provide compressions according to BLS standards, while Mech-CPR is defined as the use of a mechanical device to provide this standard of compressions (AHA, 2020). ROSC is defined as the sustained presence of sinus rhythm with a mean arterial pressure greater than 60 mmHg and significant respiratory effort after cardiac arrest (Magliocca et al., 2019). Once ROSC is achieved, chest compressions are stopped, but if the medical team is unable to achieve ROSC within the established guidelines CPR efforts are terminated, regardless of the patient’s status. The purpose of this Evidence-Based Practice review is to examine the efficacy of Man-CPR when compared to Mech-CPR in their ability to achieve ROSC in a timely manner. Nurses and other healthcare providers can use this information to help guide their practices related to choosing a methodology of compressions that will provide the best outcome for their patients. If one method of compressions is able to achieve this faster than another it could save time, resources, and lives.