Together we save: Uniting forces in manual and mechanical CPR

Mechanical chest compression devices assist rescuers in the delivery of high-quality cardiopulmonary resuscitation (CPR). 1 Poole K. Couper K. Smyth M.A. Yeung J. Perkins G.D. Mechanical CPR: Who? When? How?. Crit Care. 2018; 22: 1-9https://doi.org/10.1186/S13054-018-2059-0/TABLES/2 Google Scholar The initial enthusiasm after the introduction of this technique was followed by reservation following multiple randomized trials demonstrating that mechanical chest compressions do not confer a survival benefit compared to manual chest compressions in out-of-hospital cardiac arrest (OHCA). 2 Bonnes J.L. Brouwer M.A. Navarese E.P. et al. Manual cardiopulmonary resuscitation versus CPR including a mechanical chest compression device in out-of-hospital cardiac arrest: a comprehensive meta-analysis from randomized and observational studies. Ann Emerg Med. 2016; 67https://doi.org/10.1016/j.annemergmed.2015.09.023 Google Scholar , 3 Gates S. Quinn T. Deakin C.D. Blair L. Couper K. Perkins G.D. Mechanical chest compression for out of hospital cardiac arrest: Systematic review and meta-analysis. Resuscitation. 2015; 94: 91-97https://doi.org/10.1016/j.resuscitation.2015.07.002 Google Scholar Current CPR guidelines recommend considering mechanical CPR only if high quality manual chest compression is not practical or compromises provider safety. 4 Soar J. Böttiger B.W. Carli P. et al. European Resuscitation Council Guidelines 2021: adult advanced life support. Resuscitation. 2021; 161: 115-151https://doi.org/10.1016/j.resuscitation.2021.02.010 Google Scholar These situations include, for example, resuscitations during hospital transport, either in ambulances or helicopters, and resuscitations at the cardiac catheterization laboratory where the position of the X-ray tube and staff exposure to ionizing radiation make manual chest compression impractical and less safe. 1 Poole K. Couper K. Smyth M.A. Yeung J. Perkins G.D. Mechanical CPR: Who? When? How?. Crit Care. 2018; 22: 1-9https://doi.org/10.1186/S13054-018-2059-0/TABLES/2 Google Scholar , 5 Latsios G. Leopoulou M. Synetos A. et al. Cardiac arrest and cardiopulmonary resuscitation in "hostile" environments: Using automated compression devices to minimize the rescuers' danger. World J Cardiol. 2023; 15: 45-55https://doi.org/10.4330/WJC.V15.I2.45 Google Scholar The use of mechanical chest compression devices in these settings is widely implemented.