Rescuers’ physical fatigue with different chest compression to ventilation methods during simulated infant cardiopulmonary resuscitation

Abstract

Objective: To assess development of objective, subjective and indirect measures of fatigue during simulated infant cardiopulmonary resuscitation (CPR) with two different methods.

Methods: Using a neonatal manikin, 17 subject-pairs were randomized in a crossover design to provide 5-min CPR with a 3:1 chest compression (CC) to ventilation (C:V) ratio and continuous CCs at a rate of 120 min⁻¹ with asynchronous ventilations (CCaV-120). We measured participants’ changes in heart rate (HR) and mean arterial pressure (MAP); perceived level of fatigue on a validated Likert scale; and manikin CC measures.

Results: CCaV-120 compared with a 3:1 C:V ratio resulted in a change during 5-min of CPR in HR 49 versus 40 bpm (p = 0.01), and MAP 1.7 versus −2.8 mmHg (p = 0.03); fatigue rated on a Likert scale 12.9 versus 11.4 (p = 0.2); and a significant decay in CC depth after 90 s (p = 0.03).

Conclusions: The results indicate a trend toward more fatigue during simulated CPR in CCaV-120 compared to the recommended 3:1 C:V CPR. These results support current guidelines.

• Manikin
• neonatology
• quality

Acknowledgements

We wish to thank Helge Myklebust, Øystein Gomo and Mette Stavland, Laerdal Medical for technical support, the participating neonatal healthcare professionals who contributed to this study and Jonas Christoffer Lindstrøm, HØKH, Akershus University Hospital, Norway, for statistical guidance.

Declaration of interest

A.M.B. has received financial support from the Laerdal Foundation for Acute Medicine. Laerdal Medical (Stavanger, Norway) provided the manikin for the study. The other authors report no declarations of interest.