Abstract 233: Duration of Ventilations During CPR by Lay Rescuers Does Not Interfere with Delivering Chest Compressions
Objective: In the AHA and ERC Guidelines 2005 (G2005) and 2010 for cardiopulmonary resuscitation the importance of minimally interrupted chest compressions (cc) is emphasized. The time taken to give two breaths should not be more than 5 s to allow for a sufficient number of cc delivered. The feasibility of this recommendation for lay rescuers was questioned after manikin studies. This study aims to determine if the expected short interruption for ventilations by trained lay rescuers can be achieved in reality.
Methods: The Arrest study is a prospective database of all out-of-hospital cardiac arrest in the province North-Holland, in the Netherlands. We used Automatic External Defibrillator (AED) recordings where the chest impedance or sternal displacement was recorded during lay rescuer CPR. We excluded ECGs with a c:v ratio of 15:2, incomplete or technical deficient ECGs. Lay rescuers had received a standard ERC BLS and AED course in the past. A ventilation period was defined as a regular interruption of cc during the CPR cycle for more then 3 s where impedance changes suggest ventilations or during ventilation prompts. The chest compression fraction (ccf) was the time of the cycle that was used for cc. We analyzed the duration of each ventilation- and cc period, as well as the number of cc and ventilations during each 2 minutes CPR cycle.
Results: We included all 222 AED recordings from lay rescuer CPR from September 2010 until March 2011, trained according to the G2005. The median (IQR) interruption time for two ventilations was 7.4 s (5.8-9.3 s). Of all, 19.4% of rescuers took >10 seconds for a ventilation period. Of the lay rescuers 97% was able to give ≥60 cc min-1 and 66% to give ≥80 cc min-1. The median ccf (IQR) was 76.7% (71.4-83.4%).
Conclusion: For the great majority of lay rescuers it is feasible to give two rescue breaths in less than 7 s and to give at least 60 compressions per minute. Trained lay rescuers can deliver compressions and ventilate as recommended by the Guidelines.
- © 2011 by American Heart Association, Inc.