Jacek Smereka1, Łukasz Iskrzycki1, Elżbieta Makomaska-Szaroszyk2, Karol Bielski2, Michael Frass3, Oliver Robak3, Kurt Ruetzler4, Michael Czekajło5, Antonio Rodríguez-Núnez6, Jesús López-Herce7, Łukasz Szarpak8,9. 1. Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland., Wroclaw, Poland. 2. Lazarski University, Warsaw, Poland. 3. Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria. 4. Departments of Outcomes Research and General Anesthesia, Cleveland Clinic, Cleveland, OH, USA., Cleveland, United States. 5. Hounter Holmes McGuire Center for Simulation and Healthcare, Virginia Commonwealth University, Richmond, VA, USA, Richmond, United States. 6. Paediatric Emergency and Critical Care Division, Paediatric Area Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Santiago de Compostela, Spain. 7. Paediatric Intensive Care Department, Hospital General Universitario Gregorio Marannón, Medical School, Complutense University of Madrid, Madrid, Spain., Madrid, Spain. 8. Lazarski University, Warsaw, Poland. lukasz.szarpak@gmail.com. 9. Hounter Holmes McGuire Center for Simulation and Healthcare, Virginia Commonwealth University, Richmond, VA, USA, Richmond, United States. lukasz.szarpak@gmail.com.
Abstract
BACKGROUND: The ability to perform high-quality cardiopulmonary resuscitation is one of the basic skills for lifeguards. The aim of the study was to assess the influence of chest compression frequency on the quality of the parameters of chest compressions performed by lifeguards. METHODS: This prospective observational, randomized, crossover simulation study was performed with 40 lifeguards working in Warsaw, Wroclaw, and Poznan, Poland. The subjects then participated in a target study, in which they were asked to perform 2-min cycles of metronome-guided chest compressions at different rates: 80, 90, 100, 110, 120, 130, 140, and 150 compressions per minute (CPM). RESULTS: The study involved 40 lifeguards. Optimal chest compression score calculated by manikin software was achieved for 110-120 CPM. Chest compression depth achieved 53 (interquartile range [IQR] 52-54) mm, 56 (IQR 54-57) mm, 52.5 (IQR 50-54) mm, 53 (IQR 52-53) mm, 50 (IQR 49-51) mm, 47 (IQR 44-51) mm, 41 (IQR 40-42) mm, 38 (IQR 38-43) mm for 80, 90, 100, 110, 120, 130, 140 and 150 CPM, respectively. The percentage of chest compressions with the correct depth was lower for rates exceeding 120 CPM. CONCLUSIONS: The rate of 100-120 CPM, as recommended by international guidelines, is the optimal chest compression rate for cardiopulmonary resuscitation performed by lifeguards. A rate above 120 CPM was associated with a dramatic decrease in chest compression depth and overall chest compression quality. The role of full chest recoil should be emphasized in basic life support training.
RCT Entities:
BACKGROUND: The ability to perform high-quality cardiopulmonary resuscitation is one of the basic skills for lifeguards. The aim of the study was to assess the influence of chest compression frequency on the quality of the parameters of chest compressions performed by lifeguards. METHODS: This prospective observational, randomized, crossover simulation study was performed with 40 lifeguards working in Warsaw, Wroclaw, and Poznan, Poland. The subjects then participated in a target study, in which they were asked to perform 2-min cycles of metronome-guided chest compressions at different rates: 80, 90, 100, 110, 120, 130, 140, and 150 compressions per minute (CPM). RESULTS: The study involved 40 lifeguards. Optimal chest compression score calculated by manikin software was achieved for 110-120 CPM. Chest compression depth achieved 53 (interquartile range [IQR] 52-54) mm, 56 (IQR 54-57) mm, 52.5 (IQR 50-54) mm, 53 (IQR 52-53) mm, 50 (IQR 49-51) mm, 47 (IQR 44-51) mm, 41 (IQR 40-42) mm, 38 (IQR 38-43) mm for 80, 90, 100, 110, 120, 130, 140 and 150 CPM, respectively. The percentage of chest compressions with the correct depth was lower for rates exceeding 120 CPM. CONCLUSIONS: The rate of 100-120 CPM, as recommended by international guidelines, is the optimal chest compression rate for cardiopulmonary resuscitation performed by lifeguards. A rate above 120 CPM was associated with a dramatic decrease in chest compression depth and overall chest compression quality. The role of full chest recoil should be emphasized in basic life support training.
Entities:
Keywords:
cardiopulmonary resuscitation; chest compression; lifeguard; medical simulation; quality
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