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CPR Fatigue Is REAL – How Do Fit Rescuers Perform?

March 13, 2023

Written by Amanda Mathews

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In this study of firefighters performing CPR with feedback devices, researchers found that compression depth decreased over the course of a two-minute chest compression cycle while compression rate stayed within goal.

Why does this matter?
We know that high quality chest compressions save lives in cardiac arrest. High quality = correct depth and rate and minimizing pauses. Depth is particularly important. Anyone who has done chest compressions knows how fatiguing they can be when done correctly. These researchers wanted to investigate how chest compression performance changes over time during a cardiac arrest resuscitation.

How deep are your compressions?
This study included firefighters who had to pass monthly physical fitness tests and were trained in CPR. Data was collected on 134 patients who received CPR from this first responder group during an out of hospital cardiac arrest; each two-minute cycle of CPR was analyzed independently. Data was collected via a feedback device that was also giving the responder real time feedback. Mean chest compression depth and rate was calculated every 5 seconds during CPR.

Chest compression rate remained appropriate (100-120 compression/minute) over the course of a two-minute cycle of CPR, with the guideline rate being achieved in 92.54% of cases. There was an inverse relationship seen in depth and CPR duration, with compression depth decreasing by 3.39mm on average over the course of a two-minute CPR cycle. Mean depth was within guideline range (50-60mm) in only one-third of patient events (33.58%).

To improve this, follow recommendations to use a CPR coach when you have available personnel. This person can concentrate on giving real time feedback to responders on rate and depth of compressions and ensure roles are switched every two minutes to prevent even more fatigue.

Temporal analysis of continuous chest compression rate and depth performed by firefighters during out of hospital cardiac arrest. Resuscitation. 2023 Feb 16;185:109738. doi: 10.1016/j.resuscitation.2023.109738. Epub ahead of print.

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