Total Number Of Chest Compressions Research Articles

Introduction to ecological innovations in resuscitation training. Does made of cardboard has to mean single-use?

Aim: To assess the initial usefulness of an innovative, ecological manikin made of cardboard and coconut fiber, which is intended for resuscitation training. Material and methods: The study was conducted with the use of a mechanical chest compression device and assistance of human subjects. The first phase quantified the initial durability of the manikin. Phases two and three initially assessed manikins’ mechanical properties, its resistance to repetitive chest com¬pression training, and the quality of chest compressions performed on the tested manikin. Results: 268 and 49 participants took part in the first and the second phase of the study, respectively. The total number of chest compressions performed on the manikin was 30.736 and 4.928, respectively. The number of mechanical chest compressions reached 75.000 in phase three. The mean compression depth ranged between 47.1 ± 1.4 and 52.7 ± 0.6 mm, and the compression force ranged from 577 ± 10.0 to 686 ± 187 N. The rate of compressions ranged from 99.5 to 133/min, and the percentage of complete chest recoil ranged from 62.1 ± 20.3% to 100%. Conclusions: The tested ecological manikin invented for the purpose of resuscitation training provides the parameters necessary for students to master the ability to deliver high-quality chest compressions in terms of depth, rate, full recoil and force needed to perform chest compressions in a large adult. Durability tests showed that a manikin made of ecological materials can also be used multiple times, for many training groups.

Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity-A Manikin Study.

Background: Although there have been no reported cardiac arrests in space to date, the risk of severe medical events occurring during long-duration spaceflights is a major concern. These critical events can endanger both the crew as well as the mission and include cardiac arrest, which would require cardiopulmonary resuscitation (CPR). Thus far, five methods to perform CPR in microgravity have been proposed. However, each method seems insufficient to some extent and not applicable at all locations in a spacecraft. The aim of the present study is to describe and gather data for two new CPR methods in microgravity. Materials and Methods: A randomized, controlled trial (RCT) compared two new methods for CPR in a free-floating underwater setting. Paramedics performed chest compressions on a manikin (Ambu Man, Ambu, Germany) using two new methods for a free-floating position in a parallel-group design. The first method (Schmitz–Hinkelbein method) is similar to conventional CPR on earth, with the patient in a supine position lying on the operator’s knees for stabilization. The second method (Cologne method) is similar to the first, but chest compressions are conducted with one elbow while the other hand stabilizes the head. The main outcome parameters included the total number of chest compressions (n) during 1 min of CPR (compression rate), the rate of correct chest compressions (%), and no-flow time (s). The study was registered on clinicaltrials.gov (NCT04354883). Results: Fifteen volunteers (age 31.0 ± 8.8 years, height 180.3 ± 7.5 cm, and weight 84.1 ± 13.2 kg) participated in this study. Compared to the Cologne method, the Schmitz–Hinkelbein method showed superiority in compression rates (100.5 ± 14.4 compressions/min), correct compression depth (65 ± 23%), and overall high rates of correct thoracic release after compression (66% high, 20% moderate, and 13% low). The Cologne method showed correct depth rates (28 ± 27%) but was associated with a lower mean compression rate (73.9 ± 25.5/min) and with lower rates of correct thoracic release (20% high, 7% moderate, and 73% low). Conclusions: Both methods are feasible without any equipment and could enable immediate CPR during cardiac arrest in microgravity, even in a single-helper scenario. The Schmitz–Hinkelbein method appears superior and could allow the delivery of high-quality CPR immediately after cardiac arrest with sufficient quality.

Evaluation of Chest Compression Quality and Appropriateness in the Pediatric Cardiopulmonary Resuscitation

Background/Objective: This study aimed to verify the quality and the appropriateness of pediatric CPR chest compressions according to 2015 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Method/Statistical Analysis: The participants of this study were 64 EMT and nursing students who were quailified as BLS providers. Four sets of 5 CPR cycles were performed with one hand and two hands at the ratio of chest compression (30 times) to respiration (2 times), and fatigue was confirmed by NRS(numeral rating scale). Collected data were analyzed using frequency, descriptive statistics, paired t-test, and repeated measure ANOVA by SPSS 22.0.Findings: While the total number of chest compressions (629.6 times vs. 618.3 times, p=.016) and hands-off time (6.6 sec vs. 6.9 sec, p=.006) were effective for one-handed chest compression, average pressure depth (42.2mm vs. 43.8mm, p<.001), sufficient chest compression depth rate (83.0% vs. 89.1%, p=.038) and fatigue (7.0 points vs. 6.2 points, p=.040) were more effective in two-handed chest compressions. In addition, there were significant differences in the average chest compression depth over time(p=.003) and the total elapsed time (p=.332), but no significant difference in inappropriate chest compression.Improvements/Applications: Performing pediatric CPR according to the 2015 Guidelines for Pediatric Cardiopulmonary resuscitation is acceptable, but it is necessary to consider two-hand chest compression more than one hand compression.

The Effect of Operator Position on the Quality of Chest Compressions Delivered in a Simulated Ambulance.

Ambulances are where patient care is often initiated or maintained, but this setting poses safety risks for paramedics. Paramedics have found that in order to optimize patient care, they must compromise their own safety by standing unsecured in a moving ambulance. This study sought to compare the quality of chest compressions in the two positions they can be delivered within an ambulance. A randomized, counterbalanced study was carried out with 24 paramedic students. Simulated chest compressions were performed in a stationary ambulance on a cardiopulmonary resuscitation (CPR) manikin for two minutes from either: (A) an unsecured standing position, or (B) a seated secured position. Participants' attitudes toward the effectiveness of the two positions were evaluated. The mean total number of chest compressions was not significantly different standing unsecured (220; SD = 12) as compared to seated and secured (224; SD = 21). There was no significant difference in mean compression rate standing unsecured (110 compressions per minute; SD = 6) as compared to seated and secured (113 compressions per minute; SD = 10). Chest compressions performed in the unsecured standing position yielded a significantly greater mean depth (52 mm; SD = 6) than did seated secured (26 mm; SD = 7; P < .001). Additionally, the standing unsecured position produced a significantly higher percentage (83%; SD = 21) for the number of correct compressions, as compared to the seated secured position (8%; SD = 17; P < .001). Participants also believed that chest compressions delivered when standing were more effective than those delivered when seated. The quality of chest compressions delivered from a seated and secured position is inferior to those delivered from an unsecured standing position. There is a need to consider how training, technologies, and ambulance design can impact the quality of chest compressions.

Does the use of a chest compression system in children improve the effectiveness of chest compressions? A randomised crossover simulation pilot study.

Providing high-quality chest compressions is a key element affecting the effectiveness of cardiopulmonary resuscitation (CPR). To evaluate the effectiveness of standard (manual) chest compressions (Standard BLS, standard basic life support) and those performed with the use of the Lifeline ARM chest compression system (ARM; Defibtech). The study was designed as a randomised crossover study. In total, 37 nurses participated in the study. They performed a randomized 2-min asynchronous resuscitation using the Standard BLS method or the ARM system. The following parameters were measured: the total number of chest compressions, the frequency of compressions (min-1), compression depth (mm), and the percentage of correctly performed chest compressions and total chest decompressions. The authors also analysed the participants' preferences concerning the use of particular CPR techniques in the clinical setting. The results obtained during the simulation study with the application of the ARM system were statistically significantly better than those with the Standard BLS method (p < 0.05) in the case of all analysed parameters. During the simulated child resuscitation performed by the nurses, the application of the Lifeline ARM chest compression system significantly improved the effectiveness of chest compressions.

CPR quality reduced due to physical fatigue after a water rescue in a swimming pool

Objective. This study aimed to analyse the influence of physical fatigue, resulting from a simulated aquatic rescue, at a swimming pool, on the quality of cardiopulmonary resuscitation (CPR) delivered by the rescuer.&nbsp;Design, setting and participants. An intragroup design with 27 lifeguards was used in this study. The quality of CPR delivery was evaluated for two minutes for all subjects while they were at rest (test 1), as well as after a simulated aquatic rescue at a swimming pool (test 2). A Resusci Anne® SkillReporter™ (Laerdal Medical Limited, Norway) manikin was used to retri-eve reports on CPR delivery, compliant with the most recent international guidelines (30:2, chest compression: ventilation ratio).&nbsp;Results. Rescue-related physical fatigue had a significant influence on the total number of chest compressions as well as on the ratio of correct chest compressions. Physical fatigue triggered by a swimming pool water rescue negatively influenced CPR delivery quality. These results show that the detrimental effects of physical fatigue on CPR delivery remain important, even in a swimming pool environment.&nbsp;Conclusions. Training programs should reflect this finding, and focus on enabling lifeguards to deliver proper CPR, even while exhausted and for long periods of time.

A comparison between over-the-head and lateral cardiopulmonary resuscitation with a single rescuer by bag-valve mask

Context:mask fixation in the lateral position is difficult during CPR.Aim:the aim of this study is to compare the lateral CPR for the use of bag-valve mask by single paramedic rescuer as well as over-the-head CPR on the chest compression and ventilation on the manikin.Settings and Design:Mazandaran University of Medical Sciences. The design of this study was a randomized cross-over trial.Methods:participants learned a standardized theoretical introduction CPR according to the 2010 guidelines. The total number of chest compressions per two minutes was measured. Total number of correct and wrong ventilation per two minutes was evaluated.Statistical Analysis:we used Wilcoxon signed-rank test to analyze the non-normally distributed data in dependence groups A. P-value of more than 0.05 was considered to show statistical significance.Results:there were 100 participants (45 women and 55 men) who participated in the study from September to March, 2011. The compression and ventilation rate in lateral CPR was lower than OTH CPR. Around 51% of participants had correct chest compression rate more than 90 beats per minute in lateral CPR and 65% of them had equal or more than ten correct ventilations per minute.Conclusions:in conclusion, this study confirmed that in a simulated CPR model over-the-head position CPR led to a better BLS than the lateral position CPR by a single paramedic student with a BVM device. We also concluded that by this new BVM fixation method on the face of the patients in the lateral position CPR can be a good alternative over-the-head mask fixation by a single trained rescuer.

The Efficacy of Alternative Cardiopulmomonary Resuscitation Methods When Compared to Standard Cardiopulmonary Resuscitation: A Simulation Study

ObjectiveThere are limited data comparing the alternative cardiopulmomary resuscitation (CPR) methods (over the head CPR, straddle CPR and one hand CPR) to standard CPR performed by emergency medical technicians (EMTs). Therefore we investigated the efficacy of the alternative CPRs compared to that of standard CPR performed by EMTs in simulated cardiac arrest scenarios.MethodsThirty EMTs of intermediate level participated in this study. The performance of CPR was defined as the average depth, the total number of chest compressions, and the rate of compressions. EMTs performed three minutes of standard CPR and of alternative CPR on standard simulation mannequins with recording devices. Recorded performance was measured and compared between subgroups by the type of CPR, gender of EMTs and gender with various methods of CPR using ANOVA and t test statistics.ResultsThe average depth of compressions was 42.3±5.8, 42.6±4.7, 43.5±3.7, 33.8±6.6 mm (mean±standard deviation) respectively in standard CPR, over the head CPR, straddle CPR and one hand CPR. The total number of chest compression was 330.4±38.1, 334.8±70.2, 334.0±34.9, 312.1±53.5 in 3 minutes. The rate of compressions was found to be 111.5±10.3, 113.8±11.6, 110.5±11.2, 110.7±11.8 times per minute. The comparison of the performance qualities for the four types of CPR showed that the compression depth was significantly lower in one‐hand CPR (p&lt;0.000). No EMT gender difference in the quality of performance of total CPR was noted.ConclusionsThe efficacy of alternative CPRs are shown to be similar to that of standard CPR in a compression‐only simulation cardiac arrest model.

Performer fatigue and CPR quality comparing 30:2 to 15:2 compression to ventilation ratios in older bystanders: A randomized crossover trial

ObjectivesWe sought to compare bystander fatigue and CPR quality after 5min of CPR using the 30:2 vs. the 15:2 chest compression:ventilation ratios in a population of older participants. MethodsThis randomized cross-over study included independent-living participants aged ≥55. Participants completed two 5-min CPR sessions (using 30:2 and 15:2 ratios) on a recording manikin, separated by a 5-min rest. We measured changes in heart rate (HR), mean arterial pressure (MAP), venous lactate (VL; in selected participants), and perceived level of exhaustion (Borg Scale and subjective). CPR quality measures included total number of chest compressions and number of adequate compressions. ResultsThe 42 enrolled participants were: mean age 66.0 (range 55–84), female 69.0%, and previously CPR trained 66.7%. Measures of bystander fatigue were similar for each CPR ratio: mean difference in increased HR 1.5 (95%CI −1.5 to 4.5), MAP 1.5 (−1.8 to 4.8), VL 0.2 (−1.1 to 1.4), Borg 0.2 (−0.2 to 0.8), but subjectively reported fatigue level was higher after the 30:2 session. Participants attempted more chest compressions per session using the 30:2 vs. the 15:2 ratio: mean diff. 78.6 (69.5–87.7), but did not complete more adequate compressions: mean diff. 1.9 (−18.9 to 22.9). The decline in number of adequate compressions/min over time was significant but similar in each group. ConclusionsIn this study of older volunteers, the 30:2 CPR ratio resulted in similar objective measures of fatigue, but higher perceived fatigue than the 15:2 ratio. The 30:2 ratio resulted in proportionally more inadequate compressions.

Quality of chest compressions during continuous CPR; comparison between chest compression-only CPR and conventional CPR

Objectives This study aimed to compare the time-dependent deterioration of chest compressions between chest compression-only cardiopulmonary resuscitation (CPR) and conventional CPR. Methods This study involved 106 and 107 participants randomly assigned to chest compression-only CPR training and conventional CPR training, respectively. Immediately after training, participants were asked to perform CPR for 2 min and the quality of their CPR skills were evaluated. The number of chest compressions in total and those with appropriate depth were counted every 20-s CPR period from the start of CPR. The primary outcome was the CPR quality index calculated as the proportion of chest compressions with appropriate depth among total chest compressions. Results The total number of chest compressions remained stable over time both in the chest compression-only and the conventional CPR groups. The CPR quality index, however, decreased from 86.6 ± 25.0 to 58.2 ± 36.9 in the chest compression-only CPR group from 0–20 s through 61–80 s. The reduction was greater than in the conventional CPR group (85.9 ± 25.5 to 74.3 ± 34.0). The difference in the CPR quality index reached statistical significance ( p = 0.003) at 61–80 s period. Conclusions Chest compressions with appropriate depth decreased more rapidly during chest compression-only CPR than conventional CPR. We recommend that CPR providers change their roles every 1 min to maintain the quality of chest compressions during chest compression-only CPR. (UMIN-CTR C0000000321)

Effectiveness of simplified chest compression-only CPR training program with or without preparatory self-learning video: A randomized controlled trial

Objectives To evaluate the effectiveness of 1-h practical chest compression-only cardiopulmonary resuscitation (CPR) training with or without a preparatory self-learning video. Methods Participants were randomly assigned to either a control group or a video group who received a self-learning video before attending the 1-h chest compression-only CPR training program. The primary outcome measure was the total number of chest compressions during a 2-min test period. Results 214 participants were enrolled, 183 of whom completed this study. In a simulation test just before practical training began, 88 (92.6%) of the video group attempted chest compressions, while only 58 (64.4%) of the control group ( p < 0.001) did so. The total number of chest compressions was significantly greater in the video group than in the control group (100.5 ± 61.5 versus 74.4 ± 55.5, p = 0.012). The proportion of those who attempted to use an automated external defibrillator (AED) was significantly greater in the video group (74.7% versus 28.7%, p < 0.001). After the 1-h practical training, the number of total chest compressions markedly increased regardless of the type of CPR training program and inter-group differences had almost disappeared (161.0 ± 31.8 in the video group and 159.0 ± 35.7 in the control group, p = 0.628). Conclusions 1-h chest compression-only CPR training makes it possible for the general public to perform satisfactory chest compressions. Although a self-learning video encouraged people to perform CPR, their performance levels were not sufficient, confirming that practical training as well is essential. (UMIN000001046).

Influence of chest compression rate guidance on the quality of cardiopulmonary resuscitation performed on manikins

Aims The adequate chest compression rate during CPR is associated with improved haemodynamics and primary survival. To explore whether the use of a metronome would affect also chest compression depth beside the rate, we evaluated CPR quality using a metronome in a simulated CPR scenario. Methods Forty-four experienced intensive care unit nurses participated in two-rescuer basic life support given to manikins in 10 min scenarios. The target chest compression to ventilation ratio was 30:2 performed with bag and mask ventilation. The rescuer performing the compressions was changed every 2 min. CPR was performed first without and then with a metronome that beeped 100 times per minute. The quality of CPR was analysed with manikin software. The effect of rescuer fatigue on CPR quality was analysed separately. Results The mean compression rate between ventilation pauses was 137 ± 18 compressions per minute (cpm) without and 98 ± 2 cpm with metronome guidance ( p < 0.001). The mean number of chest compressions actually performed was 104 ± 12 cpm without and 79 ± 3 cpm with the metronome ( p < 0.001). The mean compression depth during the scenario was 46.9 ± 7.7 mm without and 43.2 ± 6.3 mm with metronome guidance ( p = 0.09). The total number of chest compressions performed was 1022 without metronome guidance, 42% at the correct depth; and 780 with metronome guidance, 61% at the correct depth ( p = 0.09 for difference for percentage of compression with correct depth). Conclusions Metronome guidance corrected chest compression rates for each compression cycle to within guideline recommendations, but did not affect chest compression quality or rescuer fatigue.

Qualität der Herz-Lungen-Wiederbelebung unter dem universellen Algorithmus 2005

Chest compressions are crucial in cardiopulmonary resuscitation (CPR), although the optimal number, rate and sequence are unknown. The 2005 CPR guidelines of the European Resuscitation Council (ERC) brought major changes to the basic life support algorithm. One of the major aims of the ERC was to decrease hands-off time in order to improve perfusion of the coronary vessels and the brain. Using a manikin model of basic life support in simulated cardiac arrest, we compared hands-off time and total number of chest compressions according to the guidelines of 2000 and those of 2005. A total of 50 volunteers performed CPR according to the guidelines of 2000 (Group 2000) and 2005 (Group 2005) in a randomized unblinded cross-over study. Volunteers received 10 min of standardized teaching and 10 min of training, including corrective feedback, for each set of guidelines before performing 5 min of basic life support on a manikin. We compared hands-off time as the primary outcome parameter and the total number of chest compressions as the secondary outcome parameter. Fifty volunteers were enrolled in the study, one individual dropped out after randomization. In Group 2005, hands-off time was significantly lower (mean 107 +/- 19 [SD] s vs. 139 +/- 15 s in Group 2000 (P < 0.0001) and the total number of chest compressions was significantly higher (347 +/- 64 compressions vs. 233 +/- 51 compressions; P < 0.0001). In this manikin setting, both hands-off time and the total number of chest compressions improved with basic life support performed according to the ERC guidelines of 2005.

Quality of chest compressions during 10 min of single-rescuer basic life support with different compression: ventilation ratios in a manikin model

Good quality basic life support (BLS) improves outcome during cardiac arrest. As fatigue may reduce BLS performance over time we wanted to examine the quality of chest compressions in a single-rescuer scenario during prolonged BLS with different compression:ventilation ratios (C:V ratios). Professional paramedics were asked to perform single-rescuer BLS with C:V ratios of 15:2, 30:2 and 50:2 for 10 min each in random order. A Laerdal Medical Resusci Anne Simulator with PC Skillreporting System was used for BLS quality analysis. Total number of chest compressions, compression depth and compression rate were measured and the differences between the C:V ratios were analysed with repeated measures ANOVA. For analysis of fatigue, chest compression variables for each 2-min period were analysed and compared with the first 2-min period using repeated measures ANOVA. Altogether 50 paramedics completed the study. The mean number of chest compressions increased significantly from 604 to 770 and 862 with C:V ratios of 15:2, 30:2 and 50:2, respectively. Chest compression rate was significantly higher with C:V ratio of 15:2 compared to 30:2 and 50:2 but was above 100 per minute for all three ratios. However, the mean chest compression depth did not change significantly between the different C:V ratios. The number of chest compressions did not change significantly with time for any of the three C:V ratios. Compression depth did decline after the first 2-min period for 30:2 and 50:2 as did compression rate for all three ratios. However all were above the guideline limits for the entire test period. Increasing the C:V ratio increases the number of chest compressions during 10 min of BLS. Compression depth and compression rate were within guideline recommendations for all three ratios. We found no decline in chest compression quality below guideline recommendations during 10 min of BLS with any of the three different C:V ratios.

Abstract 66: Effectiveness Of Cardiac-only CPR Training by Self-learning Video, a 1-hour program, or Both

[Introduction] Despite present efforts to train the general public in CPR, the proportion of bystander CPR is still low. Length of CPR training program and complexity of CPR skills may be barriers to bystander CPR performance. Recently, simple video self-learning has been shown to be an effective CPR training technique. [Objective] To evaluate the effectiveness of cardiac-only CPR training program by a self-learning video, a 1-hour practical course, or both. [Method] Designs : A randomized controlled trial. Participants: General public aged 18 years or older. Intervention: In the video (V) group, participants received the self-learning video before CPR training and then attended a 1-hour cardiac-only CPR training program; in the control (C) group participants attended the training program without a self-learning video. Data collection: Before and immediately after the training, a 2 minute scenario-based test was conducted and CPR skills were recorded. Outcomes: The primary outcome measure was the number of correct chest compressions immediately after the training. We also calculated the achievement of correct chest compressions, which meant the proportion of correct chest compressions in relation to the ideal number of chest compressions based on 2005 CPR guideline. [Result] 214 participants were randomly assigned to V (108) and C (106) groups. Before the training, the proportion of attempting chest compression, attempting AED operation, and calling for an AED, and the total number of chest compressions were significantly grater in the V group. After the training, all measured CPR skills of both groups improved substantially compared with pre-training skills, but there were no differences between groups (Table ). [Conclusion] A self-learning video improved CPR skills. However, a 1-hour practical training course was substantially more effective and the addition of a self-learning video did not improve its effectiveness. Table: CPR Skills of Pre- and Post-training

The effects of changes to the ERC resuscitation guidelines on no flow time and cardiopulmonary resuscitation quality: A randomised controlled study on manikins

The European Resuscitation Council (ERC) guidelines changed in 2005. We investigated the impact of these changes on no flow time and on the quality of cardiopulmonary resuscitation (CPR). Simulated cardiac arrest (CA) scenarios were managed randomly in manikins using ERC 2000 or 2005 guidelines. Pairs of paramedics/paramedic students treated 34 scenarios with 10min of continuous ventricular fibrillation. The rhythm was analysed and defibrillation shocks were delivered with a semi-automatic defibrillator, and breathing was assisted with a bag-valve-mask; no intravenous medication was given. Time factors related to human intervention and time factors related to device, rhythm analysis, charging and defibrillation were analysed for their contribution to no flow time (time without chest compression). Chest compression quality was also analysed. No flow time (mean+/-S.D.) was 66+/-3% of CA time with ERC 2000 and 32+/-4% with ERC 2005 guidelines (P<0.001). Human factor interventions occupied 114+/-4s (ERC 2000) versus 107+/-4s (ERC 2005) during 600-s scenarios (P=0.237). Device factor interventions took longer using ERC 2000 guidelines: 290+/-19s versus 92+/-15s (P<0.001). The total number of chest compressions was higher with ERC 2005 guidelines (808+/-92s versus 458+/-90s, P<0.001), but the quality of CPR did not differ between the groups. The use of a single shock sequence with guidelines 2005 has decreased the no flow time during CPR when compared with guidelines 2000 with multiple shocks.

Two rescuer resuscitation—Mission impossible?: A pilot study using a manikin setting

Advanced life support (ALS) in a cardiac arrest is usually performed by a team consisting of three people. The medical team of a Helicopter Emergency Medical Service (HEMS) often consists of two rescuers only. Due to that reason an algorithm was developed to provide ALS with two people. During the initial phase the rescuer in the over-the-head position provides one man CPR while the second rescuer prepares all advanced measures. When all preparations are complete both rescuers are able to provide ALS. A computer controlled manikin (Ambu Mega Code Simulator System MCS with online documentation was used to test the entire medical staff during 10 min of persistent VF. The 20 teams were tested. Following data were recorded: no-flow-time 96.4+/-11s (16.1+/-1.8%), chest compression frequency 120.1+/-5.1 min (-1), ventilation frequency=9 min (-1), number of chest compressions per session 1013.7+/-45.9, depth of chest compressions 46.6+/-2.5mm, total number of chest compressions=20,274, total number of ventilations=1893. For ALS measures the following data were recorded: tracheal intubation (TI) was finished after 60.7+/-9.8s, duration of TI : maneuver = 15.7+/-4.4s, end of initial phase=188.9+/-26.3s, i.v. administration of adrenaline after 387.7+/-33.6s, i.v. administration of amiodarone after 507.9+/-36.9s and four shocks after: 138.0+/-15.9, 266.8+/-16.1, 398.0+/-20.1 and 526.8+/-23.6s. We proved the feasibility of the algorithm in a manikin setting. Further observations have to prove the algorithm in real CPR situations.

The effect on quality of chest compressions and exhaustion of a compression–ventilation ratio of 30:2 versus 15:2 during cardiopulmonary resuscitation—A randomised trial

Recent cardio pulmonary resuscitation (CPR) guidelines changed the compression:ventilation ratio in 30:2. To compare the quality of chest compressions and exhaustion using the ratio 30:2 versus 15:2. A prospective, randomised crossover design was used. Subjects were recruited from the H.-Hart hospital personnel and the University College Katho for nurses and bio-engineering. Each participant performed 5min of CPR using either the ratio 30:2 or 15:2, then after a 15min rest switched to the other ratio. The data were collected using a questionnaire and an adult resuscitation manikin. The outcomes included exhaustion as measured by a visual analogue scale (VAS) score, depth of chest compressions, rates of chest compressions, total number of chest compressions, number of correct chest compressions and incomplete release. Data were compared using the Wilcoxon Signed Ranks Test. The results are presented as medians and interquartile ranges (IQR). One hundred and thirty subjects completed the study. The exhaustion-score using the VAS was 5.9 (IQR 2.25) for the ratio 30:2 and 4.5 (IQR 2.88) for the ratio 15:2 (P<0.001). The compression depth was 40.5mm (IQR 15.75) for 30:2 and 41mm (IQR 15.5) for 15:2 (P=0.5). The compression rate was 118beats/min (IQR 29) for 30:2 and 115beats/min (IQR 32) for 15:2 (P=0.02). The total number of compressions/5min was 347 (IQR 79) for 30:2 and 244compressions/5min (IQR 72.5) for 15:2 (P<0.001). The number of correct compression/5min was 61.5 (IQR 211.75) for 30:2 and 55.5 (IQR 142.75) for 15:2 (P=0.001). The relative risk (RR) of incomplete release in 30:2 versus 15:2 was 1.087 (95% CI=0.633-1.867). Although the 30:2 ratio is rated to be more exhausting, the 30:2 technique delivers more chest compressions and the quality of chest compressions remains unchanged.