Abstract

Introduction: Minimizing interruptions in chest compression during cardiopulmonary resuscitation (CPR) is a crucial determinant for the outcome following cardiac arrest. The International Life Saving Federation recommends lifeguards to perform CPR using mouth-to-pocket-mask ventilation (MPV). An alternative ventilation method is supraglottic airway ventilation (SAV), however the possible benefit of SAV among lifeguards is currently unknown. The aim of this study was to compare the effect of SAV and MPV on CPR quality. Materials and methods: Surf lifeguards in active service were invited to participate. MPV (Pocket Mask™, Laerdal, Stavanger, Norway) is a mandatory part of surf lifeguard training. All participants were trained in using a supraglottic airway (i-gel, Intersurgical®, Workingham, UK). Subsequently, each surf lifeguard was randomized to perform single rescuer CPR using either SAV or MPV separated by five minutes of rest. Data were obtained from a resuscitation manikin (Ambu® Cardiac Care Trainer System, Ambu, Ballerup, Denmark) and video recordings. Results: In total, 25 surf lifeguards were included (9 female, 16, male, mean age 25.2 years). All were employed as seasonal lifeguards and none of the participants were healthcare professionals. Interruptions in chest compressions were significantly reduced by SAV (mean+/-SD: 4.8+/-1.0 sec) when compared to MPV (7.8+/-1.3 sec, p<0.001). No significant difference in chest compression depth and rate were observed between groups. Time to first ventilation attempt was 1.9+/-3.0 sec faster when using MPV compared to SAV (p=0.003). No difference in effective ventilations (visible chest rise) were observed when comparing SAV (94.1%) to MPV (95.0%, p=0.96). Tidal volumes were significantly lower following MPV (0.48+/-0.19 L) compared to SAV (0.58+/-0.10 L, p=0.04). Conclusion: SAV significantly reduces interruptions in chest compressions during lifeguard CPR and is superior in delivering the recommended tidal volume compared to MPV. Our results suggest that CPR quality is improved using SAV compared to MPV among lifeguards.

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