4%]; rural, 2/105 [1.9%]; OR, 4.13; 95% CI, 1.09–34.91) [12]. This disparity is often thought to be solely as a result of longer travel distances and time between collapse and defibrillation, but it is likely to be multifactorial. Often there are fewer prehospital clinicians attending a rural cardiac arrest, compared to urban cardiac arrests, which limit the number of interventions which can be performed

concurrently whilst maintaining consistent, high quality chest compressions. The use of A-CPR has several potential advantages in a rural setting. Chest compressions are able to be provided effectively in the back of a moving vehicle en route to hospital. Without such a device, Inhibitors,research,lifescience,medical paramedics are unrestrained and are at risk of injury in a moving vehicle. Furthermore, mechanical Inhibitors,research,lifescience,medical devices do not tire, and maintain consistent depth and rate of compressions. The main disadvantage of A-CPR is the substantial weight of the device (11.6kg including battery). Limitations This study was potentially

limited by the low number of patients enrolled in the A-CPR arm during the study period. Inhibitors,research,lifescience,medical Also, treatment was not randomised in this study, however we attempted to minimize bias using a matched case–control design and by the use of propensity scores to adjust for known and unknown confounding factors. Finally, survival rates are lower in rural areas when compared to urban Inhibitors,research,lifescience,medical centres [12], making it difficult to recruit sufficient numbers to detect a difference in outcome and therefore evaluate the true utility of A-CPR in the rural and regional prehospital setting. Conclusions A-CPR may improve rate of survival to hospital over traditional C-CPR in selected settings and warrant further studies of this device, particularly examining the potential utility in rural settings. Competing interests Zoll

Medical Australia Pty Ltd provided an unrestricted grant. The funding source had no role in the study design, data collection, data analysis, Inhibitors,research,lifescience,medical data interpretation, writing of the report or the decision to submit for publication. Authors’ contributions PAJ and TS analysed the data for the present paper. PJ wrote the initial draft of the manuscript. All authors contributed to study design, interpretation of the data, intellectual discussion and revision of the manuscript. All authors have Cilengitide made substantive contributions to the study, and all authors endorse the data and conclusions. All authors read and since approved the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/12/8/prepub Acknowledgements We express our sincere thanks to the Paramedics of Ambulance Victoria who participated in this study, and Zoll Medical Australia Pty Ltd for the provision of an unrestricted grant.
Injuries are the cause of 5.8 million deaths annually which accounts for almost 10% of global mortality [1].