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. 2021 Nov 12:8:100177.
doi: 10.1016/j.resplu.2021.100177. eCollection 2021 Dec.

Different Resting Methods in Improving Laypersons Hands-Only Cardiopulmonary Resuscitation Quality and Reducing Fatigue: A Randomized Crossover Study

Xuejie Dong  1   2 , Qiang Zhou  3 , Qiuchen Lu  4 , Huiqiu Sheng  5 , Lin Zhang  6 , Zhi-Jie Zheng  1   2
Affiliations

Different Resting Methods in Improving Laypersons Hands-Only Cardiopulmonary Resuscitation Quality and Reducing Fatigue: A Randomized Crossover Study

Xuejie Dong et al. Resusc Plus. .

Abstract

Objective: To determine the effects of different resting methods with various rest-start points or rest-compression ratios on improving cardiopulmonary resuscitation (CPR) quality and reducing fatigue during continuous chest compressions (CCC) in 10-min hands-only CPR scenario.

Methods: This prospective crossover study was conducted in 30 laypersons aged 18-65. Trained participants were randomized to follow different orders to perform following hands-only CPR methods: (1) CCC, 10-min CCC; (2) 4+6, 4-min CCC + 6-min of 10-s pause after 60-s compressions; (3) 2+8 (10/60), 2-min CCC + 8-min of 10-s pause after 60-s compressions; (4) 5/30, 2-min CCC + 8-min of 5-s pause after 30-s compressions; (5) 3/15, 2-min CCC + 8-min of 3-s pause after 15-s compressions. CPR quality (depth, rate, hands-off duration, chest compression fraction (CCF)) and participants' fatigue indicators (heart rate, blood pressure, rating of perceived exertion (RPE)) were compared among methods of different rest-start points and different rest-compression ratios with CCC.

Results: Twenty-eight participants completed all methods. All resting methods reduced the trend of declining compression depth and the trend of increasing RPE while maintaining CCF of more than 86%. In methods with different rest-start points, the 2+8 method showed no difference in overall CPR quality or fatigue, but better CPR quality of every minute than 4+6 method. In methods with different rest-compression ratios, the 3/15 method showed the best CPR quality and the highest heart rate increment.

Conclusion: During prolonged hands-only CPR, appropriate transient rests were associated with higher CPR quality and lower subjectively perceived fatigue in laypersons.

Keywords: Hands-only CPR; High-quality CPR; Laypeople; Rescuer fatigue; Rest.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow diagram of the study. CCC, 10-min CCC; 4+6, 4-min CCC + 6-min of 10-s pause after 60-s compressions; 2+8 (10/60), 2-min CCC + 8-min of 10-s pause after 60-s compressions; 5/30, 2-min CCC + 8-min of 5-s pause after 30-s compressions; 3/15, 2-min CCC + 8-min of 3-s pause after 15-s compressions; CPR, cardiopulmonary resuscitation.
Fig. 2
Fig. 2
Comparison of chest compression depth, percentage of adequate compression depth, and leaning depth over 10 minutes in different methods. (n = 28) Values are shown as median and interquartile range. CCC, 10-min CCC; 4+6, 4-min CCC + 6-min of 10-s pause after 60-s compressions; 2+8 (10/60), 2-min CCC + 8-min of 10-s pause after 60-s compressions; 5/30, 2-min CCC + 8-min of 5-s pause after 30-s compressions; 3/15, 2-min CCC + 8-min of 3-s pause after 15-s compressions. ǂ Significant difference between different method (P<0.05, Friedman test); * Significant difference between the marked minute with its previous minute (P<0.05, Wilcoxon signed ranks test).
Fig. 3
Fig. 3
Comparison of rating of perceived exertion (RPE) over 10 minutes in different methods. (n = 28) Violin plot showing the medians, interquartile range, and min-max values. CCC, 10-min CCC; 4+6, 4-min CCC + 6-min of 10-s pause after 60-s compressions; 2+8 (10/60), 2-min CCC + 8-min of 10-s pause after 60-s compressions; 5/30, 2-min CCC + 8-min of 5-s pause after 30-s compressions; 3/15, 2-min CCC + 8-min of 3-s pause after 15-s compressions. ǂ Significant difference between different method (P<0.05, Friedman test); * Significant difference between the marked minute with its previous minute (P<0.05, Wilcoxon signed ranks test).
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