Is Mouth-to-mouth Ventilation Effective in Lifeguards?Comparing the Effects between 30:2 Algorithm Versus Hands-only. A Simulation Study

Abstract

Aim: Compare which resuscitation (for cardiac arrest scenario) has a higher quality when first responders with a duty of care are deprived of material: a standard resuscitation algorithm or a hands-only one when performed by lifeguards, who have had extensive training on mouth-to-mouth ventilation. Besides, a more specific objective was the analysis of the characteristics of these mouth-to-mouth ventilation. Methods: We conducted a prospective quasi-experimental crossover manikin study with clinical simulation with 41 lifeguards attached to the Plan of Surveillance and Rescue in Beaches. Each participant performed 2 minutes of basic life support (CPRb). Afterward, each participant performed 2 minutes of CPR with hands-only (CPRho). The data collection was carried out with a CPR calibrated Mannequin. Results: The mean depth was 48.05± 8.99 mm for CPRb, and 44.76 ± 9.73 mm for CPRho (t = 5.81, p < 0.001, 95% CI, 2.15 - 4.44), the rate was 123 ± 16.11 compressions/min for CPRb and 120 ± 17.89 for CPRho. The CPRho achieved a mean of 46 ± 42.6 complete chest recoil, versus 35 ± 35.19 for CPRb (z = -2.625, p = 0.009). 20.74% of ventilation were hypoventilation and 42.72% were hyperventilation. Conclusions: Mouth-to-mouth ventilation performed by lifeguards (without devices) was not effective. When ventilations were not performed, the number of high-quality compressions increased in absolute values. The mean depth of chest compressions was higher in the CPRho. Most of the participants did not perform the ventilations correctly, which resulted in time without compression and ventilation. The number of chest compressions with complete chest recoil was higher in CPRho. When ventilations were not performed, the number of high-quality compressions increased in absolute values.