TY - JOUR
T1 - Chest compression quality over time in pediatric resuscitations
AU - Badaki-Makun, Oluwakemi
AU - Nadel, Frances
AU - Donoghue, Aaron
AU - McBride, Michael
AU - Niles, Dana
AU - Seacrist, Thomas
AU - Maltese, Matthew
AU - Zhang, Xuemei
AU - Paridon, Stephen
AU - Nadkarni, Vinay M.
PY - 2013/3
Y1 - 2013/3
N2 - Background: Chest compression (CC) quality deteriorates with time in adults, possibly because of rescuer fatigue. Little data exist on compression quality in children or on work done to perform compressions in general. We hypothesized that compression quality, work, and rescuer fatigue would differ in child versus adult manikin models. Methods: This was a prospective randomized crossover study of 45 inhospital rescuers performing 10 minutes of single-rescuer continuous compressions on each manikin. An accelerometer recorded compression qualitymeasures over 30-second epochs. Work and power were calculated from recorded force data. A modified visual analogue scale measured fatigue. Data were analyzed by using linear mixed-effects models and Cox regression analysis. Results: A total of 88 484 compression cycles were analyzed. Percent adequate CCs/epoch (rate ≥ 100/minute, depth ≥ 38 mm) fell over 10 minutes (child: from 85.1% to 24.6%, adult: from 86.3% to 35.3%; P = .15) and were <70% in both by 2 minutes. Peak work per compression cycle was 13.1 J in the child and 14.3 J in the adult (P = .06; difference, 1.2 J; 95% confidence interval, 20.05 to 2.5). Peak power output was 144.1 W in the child and 166.5 W in the adult (P < .001; difference, 22.4 W, 95% confidence interval, 9.8-35.0). Conclusions: CC quality deteriorates similarly in child and adult manikin models. Peak work per compression cycle is comparable in both. Peak power output is analogous to that generated during intense exercise such as running. CC providers should switch every 2 minutes as recommended by current guidelines.
AB - Background: Chest compression (CC) quality deteriorates with time in adults, possibly because of rescuer fatigue. Little data exist on compression quality in children or on work done to perform compressions in general. We hypothesized that compression quality, work, and rescuer fatigue would differ in child versus adult manikin models. Methods: This was a prospective randomized crossover study of 45 inhospital rescuers performing 10 minutes of single-rescuer continuous compressions on each manikin. An accelerometer recorded compression qualitymeasures over 30-second epochs. Work and power were calculated from recorded force data. A modified visual analogue scale measured fatigue. Data were analyzed by using linear mixed-effects models and Cox regression analysis. Results: A total of 88 484 compression cycles were analyzed. Percent adequate CCs/epoch (rate ≥ 100/minute, depth ≥ 38 mm) fell over 10 minutes (child: from 85.1% to 24.6%, adult: from 86.3% to 35.3%; P = .15) and were <70% in both by 2 minutes. Peak work per compression cycle was 13.1 J in the child and 14.3 J in the adult (P = .06; difference, 1.2 J; 95% confidence interval, 20.05 to 2.5). Peak power output was 144.1 W in the child and 166.5 W in the adult (P < .001; difference, 22.4 W, 95% confidence interval, 9.8-35.0). Conclusions: CC quality deteriorates similarly in child and adult manikin models. Peak work per compression cycle is comparable in both. Peak power output is analogous to that generated during intense exercise such as running. CC providers should switch every 2 minutes as recommended by current guidelines.
KW - Cardiac arrest
KW - Cardiopulmonary resuscitation
KW - Chest compressions
KW - Pediatric advanced life support
KW - Power
KW - Rescuer fatigue
KW - Work
UR - http://www.scopus.com/inward/record.url?scp=84874603057&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874603057&partnerID=8YFLogxK
U2 - 10.1542/peds.2012-1892
DO - 10.1542/peds.2012-1892
M3 - Article
C2 - 23439892
AN - SCOPUS:84874603057
SN - 0031-4005
VL - 131
SP - e797-e804
JO - Pediatrics
JF - Pediatrics
IS - 3
ER -