Influence of Physical Activity of the Rescuer on Chest Compression Duration and its Effects on Hemodynamics and Fatigue Levels of the Rescuer: A Simulation-based Study

Abstract

Background Cardiopulmonary resuscitation (CPR) is a lifesaving skill performed during the cardiac arrest. Various factors of rescuer affect CPR quality, and rescuers physical fitness is one among the important factors needs to be explored for improved CPR quality. This study aimed to assess the physical activity (PA) levels of the health care providers (HCPs) who were trained in basic life support (BLS) and its relationship on chest compression duration, hemodynamic parameters, and fatigue levels of the rescuers. Materials and methods A single-center, cross-sectional study was conducted on 48 HCPs who were trained in BLS within one year. Eligible participants were contacted by email, and the responders’ level of PA was determined using the global physical activity questionnaire (GPAQ). The participants were recruited for chest compression-only cardiac arrest scenarios. Each subject performed continuous chest compression on the manikin until they perceived maximum fatigue. Heart rate (HR), blood pressure (BP), oxygen saturation (SpO 2 ), and fatigue level were assessed at baseline, immediately after and following two minutes of cessation of chest compressions. The total duration of chest compression was also documented. Results Most participants (24, 50%) reported high levels of PA while 22 (45.83%) and 2 (4.17%) reported moderate and low intensity of PA, respectively. The mean age of the 35 participants was 26.08 ± 4.60 years. The mean duration of chest compressions was 193.25 seconds with higher times reported for those with high PA when compared to those with moderate PA ( p = 0.017). Similar findings were also observed for fatigue. Conclusion Rescuers who reported high PA had lower levels of fatigue and could perform longer duration of chest compressions. How to cite this article Nayak VR, Babu A, Unnikrishnan R, Babu AS, Krishna HM. Influence of Physical Activity of the Rescuer on Chest Compression Duration and its Effects on Hemodynamics and Fatigue Levels of the Rescuer: a Simulation-based Study. Indian J Crit Care Med 2020;24(6):409–413.

Association of Training in Basic Life Support with the Evolution of Cardiopulmonary Resuscitation Performed by Firefighters

“…Te average duration of the CTEs was 3.28 minutes with a standard deviation of 1.04 minutes, with better times being achieved by those with higher levels of physical activity. Tis study concluded that the greater the physical preparation, the lower the level of fatigue and the greater the duration of the CTEs [9]. Maintaining a CTE time of approximately 5 minutes and reaching 20 uninterrupted minutes with a level of fatigue classifed as "a little difcult" are important fndings of the present study, as the literature typically describes rescuer fatigue within the frst minute of CTE [9,31,32].…”

“…Tis study concluded that the greater the physical preparation, the lower the level of fatigue and the greater the duration of the CTEs [9]. Maintaining a CTE time of approximately 5 minutes and reaching 20 uninterrupted minutes with a level of fatigue classifed as "a little difcult" are important fndings of the present study, as the literature typically describes rescuer fatigue within the frst minute of CTE [9,31,32]. It is possible that a rescuer who is capable of performing a high-quality CTE for a longer duration has a high level of physical training, which positively impacts the reduction of fatigue and maintains their muscular, physical, and cardiorespiratory capacity, ensuring their ability to efectively perform the CTE [33].…”

“…Te objective of this study was to examine the relationship between basic life support training and the efectiveness of cardiopulmonary resuscitation (CPR) performed by frefghters and to assess the correlation between the amount of training received and the time of voluntary interruption due to exhaustion during CPR. Despite the signifcance of CPR in an out-of-hospital environment and the crucial role played by frefghters in performing CPR [20], studies on the relationship between physical ftness, body composition, and the efectiveness of CPR typically do not consider frefghters as a distinct population [21], highlighting the need and importance of addressing this demographic in this context [9,12].…”

“…Efective CPR requires external chest compressions (ETCs) at a rate of 100 to 120 movements per minute and a depth of 5 to 6 centimeters in adults, emphasizing the importance of good-quality CPR and its timely implementation [1]. However, performing high-quality CPR can lead to rescuer fatigue [6,7] causing a decrease in the quality of ETCs during CPR after two minutes [8,9], which is why it is recommended that rescuers be replaced every two minutes [1].…”

Trained Lifeguards Performing Pediatric Cardiopulmonary Resuscitation While Running: A Pilot Simulation Study

“…An unexpected result of our study was that rescuers had no difficulty performing compressions of adequate depth with the manikin on their forearm, despite it not being on a firm surface. This may be related to the good physical condition of the rescuers, since it has been reported that physical training has a positive impact on chest compressions [ 29 ]. However, we must take into account that the evaluation of physical condition was based on the subjective perception of the rescuers.…”