Evaluation of compressor fatigue at 150 compressions per minute during cardiopulmonary resuscitation using a large dog manikin

Objective

To determine whether CPR providers can perform chest compressions (CC) appropriately at a rate of 150 compressions per minute during a 2-minute cycle and to identify the presence of rescuer fatigue.

Design

High fidelity simulator study.

Setting

University veterinary teaching hospital.

Subjects

Sixty subjects, 30 women and 30 men.

Interventions

Subjects performed CC at 150 compressions per minute on a dog manikin for 2 minutes. Real-time depth of compressions, compression release, and compression rate were measured using a CPR training device. Demographic data from the subjects were analyzed alongside data obtained from the monitoring device.

Measurements and Main Results

Only 38.3% of participants were able to perform CC with appropriate depth and release at 150 compressions per minute during a 2-minute cycle. There was a decay in the quality of CC between the first and the second minute. The number of compressions and percentage of compressions with correct release were similar among various genders, ages, and professions. In contrast, the percentage of compressions with correct depth was significantly higher among individuals with higher body mass index (correlation coefficient [r] = 0.293; P = 0.023) and higher biceps brachii muscle circumference during muscle contraction (r = 0.423; P = 0.001).

Conclusions

This study suggests that increasing the compression rate to 150 compressions per minute in large dogs using the thoracic pump technique might not be viable because most participants were not able to sustain enough appropriate CC. Rescuer fatigue affects compression depth at this rate, leading to a decay in CPR quality.