Why should we switch chest compression providers every 2 minutes during cardiopulmonary resuscitation?

Je Hyeok Oh ,Sang Dae Lee ,Jun Young Hong

doi:10.22514/sv142.102018.4

Abstract

Objective. This study was conducted to determine whether trained male rescuers could maintain adequate chest compres-sion depth (CCD) for longer than the cur-rent recommended guidelines of 2 minutes. Methods. Forty male medical doctors ad-ministered a 5-minute single rescuer car-diopulmonary resuscitation (CPR) to a manikin on the floor with conventional CPR or randomly administered continu-ous chest compressions (CCC). The ratio of compression to ventilation was set to 30:2 with mouth-to-mouth technique dur-ing conventional CPR. Chest compression data were recorded with an accelerometer device and divided into 1-minute segments for analysis.Results. Although average CCD main-tained the recommended depths through-out 5 minutes in conventional CPR, it de-creased significantly with CCC (1 minute: 55.4 ± 4.5 mm; 2 minutes: 54.2 ± 5.4 mm; 3 minutes: 52.6 ± 5.6 mm; 4 minutes: 51.6 ± 5.5 mm; 5 minutes: 49.9 ± 5.8 mm, p < 0.001). The average chest compression numbers (ACCN) per minute were main-tained over 80/min and have not been changed significantly within 5 minutes in the CCC. However, it didn’t reach to the 80/min and decreased significantly after 3minutes compared to the baseline ACCN during first 1-minute segment in the con-ventional CPR.Conclusions. Despite the chest compres-sion providers being limited to trained male medical doctors, the average CCD decreased significantly within 5minutes with CCC. Although maintaining adequate CCD, ACCN in each minute decreased sig-nificantly after 3minutes in the conventional CPR. Therefore, we should rotate chest compression providers every 2minutes re-gardless of the rescuer’s qualifications and CPR methods.

Highlights

The 2015 cardiopulmonary resuscitation (CPR) guidelines recommend that the chest compression providers should rotate every two minutes or sooner. [1]This is because chest compression depth (CCD) starts to deteriorate significantly after 1.5 to 2 minutes of continuous chest compressions (CCC). [2] On the other hand, CCD decreases more slowly when the chest compression provider uses the conventional CPR method with a compression to ventilation ratio of 30:2
Study design This was a prospective randomized trial comparing the quality of chest compression between CCC and conventional CPR performed by trained male rescuers
average chest compression numbers (ACCN) in each minute was significantly higher in the CCC than in the conventional CPR (117.1 ± 8.8 vs. 75.2 ± 7.2 number/min, respectively, p < 0.001)

Summary

Introduction

The 2015 cardiopulmonary resuscitation (CPR) guidelines recommend that the chest compression providers should rotate every two minutes or sooner. [1]This is because chest compression depth (CCD) starts to deteriorate significantly after 1.5 to 2 minutes of continuous chest compressions (CCC). [2] On the other hand, CCD decreases more slowly when the chest compression provider uses the conventional CPR method with a compression to ventilation ratio of 30:2. [3] the chest compressor could maintain adequate CCD for a longer period with conventional CPR. [3] the chest compressor could maintain adequate CCD for a longer period with conventional CPR. The 2015 cardiopulmonary resuscitation (CPR) guidelines recommend that the chest compression providers should rotate every two minutes or sooner. [2] On the other hand, CCD decreases more slowly when the chest compression provider uses the conventional CPR method with a compression to ventilation ratio of 30:2. [4,5,6,7,8] If we could restrict the chest compression provider to trained male rescuers, the chest compression quality might be improved. We hypothesized that trained male rescuers could maintain adequate CCD for longer than the current recommended guidelines of 2 minutes. This study was conducted to confirm our hypothesis in two different CPR methods: conventional CPR and CCC

Methods

Results

Conclusion