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Rescuer-limited cardiopulmonary resuscitation as an alternative to 2-min switched CPR in the setting of inhospital cardiac arrest: a randomised cross-over study
  1. Choong Hyun Jo1,
  2. Gyu Chong Cho1,
  3. Jung Hwan Ahn1,
  4. Yoo Seok Park2,
  5. Chang Hee Lee3
  1. 1Department of Emergency Medicine, School of Medicine, Hallym University, Seoul, Republic of Korea
  2. 2Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
  3. 3Department of Emergency Medical Services, Namseoul University, Cheonan-city, Choongnam, Republic of Korea
  1. Correspondence to Dr Gyu Chong Cho, Department of Emergency Medicine, School of Medicine, Hallym University, 445 Gil-dong, Gang-dong gu, Seoul 134-701, Republic of Korea; emdrcho{at}empas.com

Abstract

Background The 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) recommend that chest compression be rotated every 2 min to prevent rescuer fatigue. However, the quality of chest compression using 2-min switched CPR tends to decrease rapidly due to rescuer fatigue. We aimed to compare the effectiveness of use of 2-min switched CPR and rescuer-limited CPR (the person performing compressions is allowed to switch with another rescuer prior to 2 min if feeling fatigued) in the setting of inhospital cardiac arrest.

Methods Using a randomised cross-over trial design, 90 medical students were grouped into pairs to perform four cycles of 2-min switched CPR and rescuer-limited CPR (495 s per technique). During each trial, the total number of compressions performed, mean depth of compression and proportion of effective compressions performed (compression depth >5 mm) were recorded for identification of significant differences and changes in pulse rate and RR were measured to determine the extent of exhaustion.

Results Compared with 2-min switched CPR, the mean compression was deeper (51 vs 47 mm, p<0.001), total number of compressions greater (476 vs 397, p=0.003) and proportion of effective compressions greater (56% vs 47%, p=0.004) during rescuer-limited CPR. Subgroup analysis by 30-s unit showed more consistent compression quality during rescuer-limited CPR. No significant differences in change in pulse rate and RR were found between the two techniques.

Conclusions Rescuer-limited CPR yields a greater number of effective compressions and more consistent quality of CPR than 2-min switched CPR. Rescuer-limited CPR might be a suitable alternative for treating inhospital cardiac arrest.

  • resuscitation
  • cardiac arrest

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