Effects of compression-to-ventilation ratio on compression force and rescuer fatigue during cardiopulmonary resuscitation

Hsien, Chih; Tsou, Jui Yi; Su, Fong Chin

doi:10.1016/j.ajem.2009.06.022

Cited by 27 publications

(19 citation statements)

References 28 publications

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“…It has been assumed that it is possible to prolong the period of time between rescuer change even up to 10 minutes. This suggestion seems to be reasonable as none of the participants of this study mentioned fatigue, and in other sources, fatigue was the most frequently noted factor demanding rescuer change during external cardiac massage [10,17,19,20,21]. Other complaints (wrist pain, knee pain, lumbosacralis pain) indicated by the CCC-CPR rescuers were similar to those found in other sources but they came out relatively late during observation and were not a reason to stop resuscitation [22].…”

Section: Discussionmentioning

confidence: 49%

Depth and rate of chest compression in CPR simulation during 10-minute continuous external cardiac compression

Bucki

Karpe

Michnik

et al. 2017

Ann. Acad. Med. Siles.

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Depth and rate of chest compression in CPR simulation during 10-minute continuous external cardiac compressionOcena głębokości i częstotliwości kompresji klatki piersiowej podczas symulacji resuscytacji krążeniowo-oddechowej, w trakcie 10-minutowego ciągłego zewnętrznego masażu serca AB ST R ACT I N T R O D U C T I O N:External cardiac massage has been a basic CPR maneuver for years. The aim of the study was to assess the quality of chest compression during a real-time continuous cardiac compression simulation on a cardiopulmonary resuscitation mannequin (considering medical rescuer experience and BMI). M A T E R I A L A N D M E T H O D S:This was a prospective study involving 17 medical rescuers, and 21 Medical Rescue students and university lecturers. During the simulation the participants performed continuous external cardiac compression for 15 minutes or until the refusal to continue. The depth and rate were analyzed at 60-second periods, leading to average values of cardiopulmonary resuscitation effectiveness. The analysis covered complete research data gathered in real time (10 minute periods). R E S U L T S:The average compression depth significantly decreased from the first (40.66 SE ± 0.80 mm) to the fourth minute of the study (38.21 SE ± 0.95 mm). The average compression rate was significantly different between the initial values (120.97 SE ± 2.83/min) and the sixth minute of the study (123.69 SE ± 2.55/min). The average compression depth amounted to n 36.03 SE ± 1.22 mm in non-professionals and 40.06 SE ± 1.37 mm in professionally active participants. In the participants with a BMI > 25, the only differentiating point in time was the beginning of the task when the average compression depth was 41.97 SE ± 1.12 mm. In the participants with a BMI < 25, there was a gradual decrease in the compression depth within the initial four minutes of the task.

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Section: Discussionmentioning

confidence: 49%

Depth and rate of chest compression in CPR simulation during 10-minute continuous external cardiac compression

Bucki

Karpe

Michnik

et al. 2017

Ann. Acad. Med. Siles.

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“…In another manikin study (LOE 6), the quality of chest compressions significantly declined after the first minute of CPR, although rescuers on average did not identify fatigue until they had performed 2 minutes of CPR . Three additional manikin studies (LOE 6) suggested chest compressions for 3 minutes or longer was associated with loss of compression quality …”

Section: Hand Placement (Bls05)mentioning

confidence: 99%

RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 3: Basic life support

Hopper

Epstein

Fletcher

et al. 2012

J Vet Emergen Crit Care

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Objective -To systematically examine the evidence on basic life support (BLS) in veterinary CPR and to determine knowledge gaps. Design -Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Relevant questions were answered on a worksheet template and reviewed by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) BLS domain members, by the RECOVER committee and opened for comments by veterinary professionals for 30 days. Setting -Academia, referral practice, and general practice. Results -Sixteen worksheets were prepared to evaluate techniques for chest compression and ventilation strategies as well as identification of cardiopulmonary arrest (CPA). Major recommendations arising from this evidence review include performing chest compressions at a rate of at least 100/min at a compression depth of one-third to half the width of the chest with minimal pauses, and early instigation of ventilation at a rate of 8-10 breaths/min in intubated patients, or using a 30:2 compression/ventilation ratio in nonintubated patients. Conclusions -Although veterinary clinical trials are lacking, much of the experimental literature on BLS utilized canine models. The major conclusions from this analysis of the literature are the importance of early identification of CPA, and immediate initiation of BLS in these patients. Many knowledge gaps exist, most importantly in our understanding of the optimal hand placement and technique for chest compressions, warranting coordinated future studies targeted at questions of relevance to differences between veterinary species and humans. (J Vet Emerg Crit Care 2012; 22(S1): 26-43)

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“…A duty cycle (ie, time spent in compression to relaxation) of 50% is still recommended, as well as allowing full thoracic wall recoil . It is also recommended to rotate the compressor every 2 minutes, especially with higher compression rates as fatigue decreases efficacy of compressions, and may occur sooner with increased compression frequency . In human CPR, rescuer fatigue occurs within 1 minute however may not be recognized until as late as 5 minutes …”

Section: Circulationmentioning

confidence: 99%

“…39 It is also recommended to rotate the compressor every 2 minutes, especially with higher compression rates as fatigue decreases efficacy of compressions, and may occur sooner with increased compression frequency. 75 In human CPR, rescuer fatigue occurs within 1 minute however may not be recognized until as late as 5 minutes. 39,76,77 The concept of "push hard, push fast" was emphasized with the updated recommendation of at least 100 compressions per minute in the 2010 AHA recommendations.…”

Section: Circulationmentioning

confidence: 99%

Updates in theAmericanHeartAssociation guidelines for cardiopulmonary resuscitation and potential applications to veterinary patients

Maton¹,

Smarick²

2012

J Vet Emergen Crit Care

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Effects of compression-to-ventilation ratio on compression force and rescuer fatigue during cardiopulmonary resuscitation

Cited by 27 publications

References 28 publications

Depth and rate of chest compression in CPR simulation during 10-minute continuous external cardiac compression

Depth and rate of chest compression in CPR simulation during 10-minute continuous external cardiac compression

RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 3: Basic life support

Updates in theAmericanHeartAssociation guidelines for cardiopulmonary resuscitation and potential applications to veterinary patients

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