Comparison of CPR quality and rescuer fatigue between standard 30:2 CPR and chest compression-only CPR: a randomized crossover manikin trial.

Jonghwan Shin,Yong Joon Kim,Jin Joo Kim,Hui Jai Lee,Bong Yeun Koh,Yeong Ju Son,Seong Youn Hwang,Ji Seon Seo,Jung Eun Lee,Chang Je Park,In Mo Lee,Sung Gi Hong

doi:10.1186/s13049-014-0059-x

Abstract

ObjectiveWe aimed to compare rescuer fatigue and cardiopulmonary resuscitation (CPR) quality between standard 30:2 CPR (ST-CPR) and chest compression only CPR (CO-CPR) performed for 8 minutes on a realistic manikin by following the 2010 CPR guidelines.MethodsAll 36 volunteers (laypersons; 18 men and 18 women) were randomized to ST-CPR or CO-CPR at first, and then each CPR technique was performed for 8 minutes with a 3-hour rest interval. We measured the mean blood pressure (MBP) of the volunteers before and after performing each CPR technique, and continuously monitored the heart rate (HR) of the volunteers during each CPR technique using the MRx monitor. CPR quality measures included the depth of chest compression (CC) and the number of adequate CCs per minute.ResultsThe adequate CC rate significantly differed between the 2 groups after 2 minutes, with it being higher in the ST-CPR group than in the CO-CPR group. Additionally, the adequate CC rate significantly differed between the 2 groups during 8 minutes for male volunteers (p =0.012). The number of adequate CCs was higher in the ST-CPR group than in the CO-CPR group after 3 minutes (p =0.001). The change in MBP before and after performing CPR did not differ between the 2 groups. However, the change in HR during 8 minutes of CPR was higher in the CO-CPR group than in the ST-CPR group (p =0.007).ConclusionsThe rate and number of adequate CCs were significantly lower with the CO-CPR than with the ST-CPR after 2 and 6 minutes, respectively, and performer fatigue was higher with the CO-CPR than with the ST-CPR during 8 minutes of CPR.

Highlights

According to the 2010 cardiopulmonary resuscitation (CPR) guidelines, all rescuers should provide chest compressions (CC) to victims of cardiac arrest
The 2010 CPR guidelines encourage CC-only CPR (CO-CPR) for the untrained lay rescuer owing to reluctance to perform mouth-to-mouth ventilation for unknown victims of cardiac arrest, and because it is a simplified method of CPR
CCs combined with rescue breaths are the method of choice for CPR delivered by both trained lay rescuers and professionals

Summary

Introduction

According to the 2010 cardiopulmonary resuscitation (CPR) guidelines, all rescuers should provide chest compressions (CC) to victims of cardiac arrest. High quality chest compression, which is defined as a compression depth of at least 5 cm and a rate of at least 100 CCs per minute, should be performed by a lay rescuer or healthcare provider. Observational studies of adults with cardiac arrest treated by lay rescuers have shown similar survival rates among victims receiving CO-CPR versus standard 30:2 CPR (ST-CPR) with rescue breaths [3,4,5,6,7]. We aimed to compare rescuer fatigue and CPR quality between ST-CPR and CO-CPR performed on a realistic manikin according to the 2010 CPR guidelines

Methods

Results

Conclusion