1. To review and analyse the literature regarding out-of-hospital external chest compressions
(ECC) in severe asthma and status asthmaticus.
2. To compare which ambulance services in Australia and New Zealand actively use ECC in their clinical practice guidelines for severe asthma.
Literature review using a variety of medical databases including, Medline, AMED, ProQuest, EMBASE, CINAHL, Scopus and Cochrane Library from 1950 to present. The following keywords were used in the search strategy, ambulance, asthma, emergency medical technicians, external chest compression, external chest pressure, lateral chest compression, lateral chest pressure, out-of-hospital, paramedic, prehospital, status asthmaticus and thoracic compression. A review of Australian and New Zealand ambulance service clinical practice guidelines was also undertaken comparing the current out-of-hospital guidelines use of ECC.Results
A total of nine papers were located with low levels of evidence supporting the use of ECC. Only two papers directly discussed ECC in the context of out-of-hospital care. Three of the eight Australian ambulance services actively use ECC in their clinical practice guidelines.Conclusion
High level evidence was not found supporting the use of ECC in severe asthma or status asthmaticus. Anecdotal opinions and case reports generally have supported its use in dynamic hyperinflation settings. Further research is required before recommendations can be made.