Abstract 170: Chest Compression Performance Evaluation: Introduction and Utilization of the Quality Compression Index in a Manikin Model
Purpose: Both standard cardiopulmonary resuscitation (CPR) and continuous chest-compression CPR require rescuers to push hard and fast. In practice, both techniques require the optimal delivery of chest compressions. However, the performance of chest compressions and the degree by which fatigue affects performance has not been well-documented in a larger, older, and more diversified sample. It was hypothesized that rescuer fatigue would lead to decreased performance after the first two minutes, which is the current recommended time to switch compressors.
Methods: In this observational study, basic life support (BLS)-certified healthcare providers were evaluated based on their ability to provide 10 minutes of continuous chest compressions. Compression depth, rate, chest recoil, and hand position were recorded in 30 second intervals using the Laerdal PC Skillreporting System. Adequate compressions were recorded as having adequate depth (>38 mm), correct hand position, and complete recoil. Investigators developed a Quality Compression Index (QCI), which factors rate into the characteristics of an adequate compression. QCI is a scale of 10 possible points and was calculated for each 30 seconds.
Results: To date, 46 healthcare providers have completed the study. The average age of participants was 27 (±13) years and consisted of both prehospital and in-hospital healthcare providers. Only 8.7% stopped early because they were too tired to continue. Within the first minute, the number of compressions with adequate depth decreased from 74% to 64%, and decreased to 58% by the end of 10 minutes. This decline in depth reached a plateau between 90 and 120 seconds. Between 6 and 10 minutes, correct hand positions decreased from 85% to 74%. Eight (17.3%) participants had <10 compressions that met adequate depth. Average QCI decreased at a steady rate and did not show a plateau.
Conclusions: There is a steady decrease in the performance of chest compressions as measured by the QCI. QCI varied significantly between different rescuers more than it varied for a single rescuer. This can be attributed to rescuers not knowing that they are not compressing enough. We recommend changes to BLS classes to include quantitative feedback with regards to compression depth.
- © 2010 by American Heart Association, Inc.