BACKGROUND:Chest compression (CC) quality deteriorates with time in adults, possibly because of rescuer fatigue. Little data exist on compression quality in children or on work done to perform compressions in general. We hypothesized that compression quality, work, and rescuer fatigue would differ in child versus adult manikin models. METHODS: This was a prospective randomized crossover study of 45 in-hospital rescuers performing 10 minutes ofsingle-rescuer continuous compressions on each manikin. An accelerometer recorded compression quality measures over 30-second epochs. Work and power were calculated from recorded force data. A modified visual analogue scale measured fatigue. Data were analyzed by using linear mixed-effects models and Cox regression analysis. RESULTS: A total of 88 484 compression cycles were analyzed. Percent adequate CCs/epoch (rate ≥ 100/minute, depth ≥ 38 mm) fell over 10 minutes (child: from 85.1% to 24.6%, adult: from 86.3% to 35.3%; P = .15) and were <70% in both by 2 minutes. Peak work per compression cycle was 13.1 J in the child and 14.3 J in the adult (P = .06; difference, 1.2 J; 95% confidence interval, -0.05 to 2.5). Peak power output was 144.1 W in the child and 166.5 W in the adult (P < .001; difference, 22.4 W, 95% confidence interval, 9.8-35.0). CONCLUSIONS:CC quality deteriorates similarly in child and adult manikin models. Peak work per compression cycle is comparable in both. Peak power output is analogous to that generated during intense exercise such as running. CC providers should switch every 2 minutes as recommended by current guidelines.
RCT Entities:
BACKGROUND: Chest compression (CC) quality deteriorates with time in adults, possibly because of rescuer fatigue. Little data exist on compression quality in children or on work done to perform compressions in general. We hypothesized that compression quality, work, and rescuer fatigue would differ in child versus adult manikin models. METHODS: This was a prospective randomized crossover study of 45 in-hospital rescuers performing 10 minutes of single-rescuer continuous compressions on each manikin. An accelerometer recorded compression quality measures over 30-second epochs. Work and power were calculated from recorded force data. A modified visual analogue scale measured fatigue. Data were analyzed by using linear mixed-effects models and Cox regression analysis. RESULTS: A total of 88 484 compression cycles were analyzed. Percent adequate CCs/epoch (rate ≥ 100/minute, depth ≥ 38 mm) fell over 10 minutes (child: from 85.1% to 24.6%, adult: from 86.3% to 35.3%; P = .15) and were <70% in both by 2 minutes. Peak work per compression cycle was 13.1 J in the child and 14.3 J in the adult (P = .06; difference, 1.2 J; 95% confidence interval, -0.05 to 2.5). Peak power output was 144.1 W in the child and 166.5 W in the adult (P < .001; difference, 22.4 W, 95% confidence interval, 9.8-35.0). CONCLUSIONS: CC quality deteriorates similarly in child and adult manikin models. Peak work per compression cycle is comparable in both. Peak power output is analogous to that generated during intense exercise such as running. CC providers should switch every 2 minutes as recommended by current guidelines.
Authors: Aaron J Donoghue; Maybelle Kou; Grace L Good; Carmel Eiger; Mark Nash; Fred M Henretig; Helen Stacks; Adam Kochman; Julie Debski; Jia-Yuh Chen; Gaurav Sharma; Christoph P Hornik; Leigh Gosnell; David Siegel; Steven Krug; Mark D Adler Journal: Pediatr Emerg Care Date: 2020-06 Impact factor: 1.602
Authors: Jorge López; Sarah N Fernández; Rafael González; María J Solana; Javier Urbano; Blanca Toledo; Jesús López-Herce Journal: PLoS One Date: 2017-11-30 Impact factor: 3.240
Authors: Ali Jalali; Allan F Simpao; Jorge A Gálvez; Robert A Berg; Vinay M Nadkarni; Chandrasekhar Nataraj Journal: Comput Math Methods Med Date: 2018-11-29 Impact factor: 2.238