Journal Article

Rescuer fatigue under the 2010 ERC guidelines, and its effect on cardiopulmonary resuscitation (CPR) performance

Heggie, James, Thorne, Christopher J, Jones, Christopher M, Hulme, Jonathan, McDonald, Catherine H

2013

Overview

Background Updated life-support guidelines were published by the European Resuscitation Council (ERC) in 2010, increasing the required depth and rate of chest compression delivery. This study sought to determine the impact of these guidelines on rescuer fatigue and cardiopulmonary resuscitation (CPR) performance. Methods 62 Health science students performed 5 min of conventional CPR in accordance with the 2010 ERC guidelines. A SkillReporter manikin was used to objectively assess temporal change in determinants of CPR quality. Participants subjectively reported their end-fatigue levels, using a visual analogue scale, and the point at which they believed fatigue was affecting CPR delivery. Results 49 (79%) participants reported that fatigue affected their CPR performance, at an average of 167 s. End fatigue averaged 49.5/100 (range 0–95). The proportion of chest compressions delivered correctly decreased from 52% in min 1 to 39% in min 5, approaching significance (p=0.071). A significant decline in chest compressions reaching the recommended depth occurred between the first (53%) and fifth (38%) min (p=0.012). Almost half this decline (6%) was between the first and second minutes of CPR. Neither chest compression rate, nor rescue breath volume, were affected by rescuer fatigue. Conclusion Fatigue affects chest compression delivery within the second minute of CPR under the 2010 ERC guidelines, and is poorly judged by rescuers. Rescuers should, therefore, be encouraged to interchange after 2 min of CPR delivery. Team leaders should be advised to not rely on rescuers to self-report fatigue, and should, instead, monitor for its effects.

• Publisher: BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine,BMJ Publishing Group LTD
• Subject: 2010 European resuscitation Council guidelines / Adolescent / Adult / basic life support / cardiac arrest / Cardiopulmonary resuscitation / Cardiopulmonary Resuscitation - methods / Cardiopulmonary Resuscitation - standards / CPR / Death, Sudden, Cardiac / Defibrillators / Ethnicity / Fatigue - etiology / Female / Females / Heart Arrest - therapy / Humans / Male / manikin / Manikins / Practice Guidelines as Topic - standards / Quality / rescuer fatigue / Self Report / Sex Factors / Students / Studies / Time Factors / Young Adult