Abstract
Survival outcomes increase significantly when cardiopulmonary resuscitation (CPR) is provided correctly, but rescuers’ fatigue can compromise its delivery. We investigated the effect of two exercise modes on CPR effectiveness and physiological outputs. After 4 min baseline conditions, 30 lifeguards randomly performed a 100 m run and a combined water rescue before 4 min CPR (using an adult manikin and a 30:2 compression–ventilation ratio). Physiological variables were continuously measured during baseline and CPR using a portable gas analyzer (K4b2, Cosmed, Rome, Italy) and CPR effectiveness was analyzed using two HD video cameras. Higher oxygen uptake (23.0 ± 9.9 and 20.6 ± 9.1 vs. 13.5 ± 6.2 mL·kg·min−1) and heart rate (137 ± 19 and 133 ± 15 vs. 114 ± 15 bpm), and lower compression efficacy (63.3 ± 29.5 and 62.2 ± 28.3 vs. 69.2 ± 28.0%), were found for CPRrun and CPRswim compared to CPRbase. In addition, ventilation efficacy was higher in the rescues preceded by intense exercise than in CPRbase (49.5 ± 42.3 and 51.9 ± 41.0 vs. 33.5 ± 38.3%), but no differences were detected between CPRrun and CPRswim. In conclusion, CPRrun and CPRswim protocols induced a relevant physiological stress over each min and in the overall CPR compared with CPRbase. The CPRun protocol reduces the compression rate but has a higher effectiveness percentage than the CPRswim protocol, in which there is a considerably higher compression rate but with less efficacy.
Highlights
Cardiopulmonary resuscitation (CPR) after a life-threatening emergency is often performed in a non-resting state, with rescuers running at high intensity, swimming, carrying a victim, or acting in adverse heat or humidity conditions [1,2,3]
Our current data indicate low percentages of ventilation efficacy for the three experimental conditions, but performing CPRrun and CPRswim significantly increased CPR ventilation technical-related variables in our trained certified lifeguards
CPR cycle and in the overall CPR manoeuvres. Both CPRrun and CPRswim were conducted in the heavy exercise intensity domain despite the higher physiological values obtained after running
Summary
Cardiopulmonary resuscitation (CPR) after a life-threatening emergency is often performed in a non-resting state, with rescuers running at high intensity, swimming, carrying a victim, or acting in adverse heat or humidity conditions [1,2,3]. This uncertainty evidences the pertinence of standard life saving procedures and how to behave in different operational contexts. In an out of hospital emergency, it is fundamental to ensure sufficient oxygenated blood flow, minimizing ischemic damage. Relevant relationships between survival outcomes and CPR quality (e.g., chest compression depth, rate and fraction) have been repeatedly displayed [7,8,9,10]
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