Abstract 2833: Do We Need to Switch Rescuers Every Two Minutes?
Purpose: Current CPR guidelines recommend switching rescuers performing chest compressions (CC) every two minutes. These interruptions in CC may result in deleterious decreases in cardiocerebral perfusion. Using a CPR feedback device, we assessed the physiologic need to change rescuers every two minutes.
Methods: This is a randomized controlled study of 25 hospital nurses performing 6 minutes of CC according to 2005 AHA CPR guidelines for adults on a simulator (ResusciAnne Skill Reporter, Laerdal Medical). Group A performed CC using an accelerometer-based CPR feedback device (PocketCPR™, ZOLL Medical) (FCC). The control group performed CC without the device (SCC). Compression depth (CD) and rate were monitored continuously. Each subject indicated whether they exercised regularly (ER) and rated perceived fatigue (PF) on a scale of 0 to 100%.
Results: The proportion of participants providing adequate CD decreased over time in both groups, but was significantly lower in SCC vs. FCC at every minute (67% vs. 100%, 58% vs. 100%, 50% vs. 100%, 50% vs. 92%, 50% vs. 92%, and 50% vs. 84% at 1, 2, 3, 4, 5, and 6 minutes respectively, p<0.05). The CD was also higher, though not significantly, in participants who ER compared with those who did not (85% vs. 75%, 85% vs. 50%, 80% vs. 50%, 75% vs. 50%, 75% vs. 50%, and 75% vs. 75% at 1, 2, 3, 4, 5, and 6 minutes respectively, p=0.25). PF was significantly higher in the 2nd two minute segment compared with the 1st two minute segment in both groups (40±19% vs. 21±15%, p=0.004);however, PF did not correlate with actual CC quality (r=0.37).
Conclusions: Without CPR feedback, compression quality was inadequate at all time intervals. With FCC, quality compressions were provided; however, PF increased and CD declined slightly approaching 4 minutes of CC on average, at which time rescuer switching would be recommended. With FCC, rescuer switching could be tailored to individual rescuer’s physical condition and interruptions in chest compression could be reduced.