A randomized trial on elderly laypersons' CPR performance in a realistic cardiac arrest simulation

• Published in: Acta anaesthesiologica Scandinavica 2012-01, Vol.56 (1), p.124-131
• Main Authors: NESET, A., BIRKENES, T. S., FURUNES, T., MYKLEBUST, HE, MYKLETUN, R. J., ODEGAARD, S., OLASVEENGEN, T. M., KRAMER-JOHANSEN, J.
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiopulmonary Resuscitation - education; Data Collection; Educational Status; Fatigue - etiology; Fatigue - psychology; Female; Heart Arrest - therapy; Heart Rate - physiology; Humans; Hydrocortisone - metabolism; Male; Manikins; Medical sciences; Middle Aged; Pain Measurement; Patient Simulation; Saliva - chemistry; Telephone
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2011.02566.x

Background Bystander cardiopulmonary resuscitation (CPR) is important for survival after cardiac arrest. We hypothesized that elderly laypersons would perform CPR poorer in a realistic cardiac arrest simulation, compared to a traditional test. Methods Sixty‐four lay rescuers aged 50–75 were randomized to realistic or traditional test, both with ten minutes of telephone assisted CPR. Realistic simulation started suddenly without warning, leaving the test subject alone in a confined and noisy apartment. Traditional test was conducted in a spacious and calm classroom with a researcher present. CPR performance was recorded with a manikin with human like chest properties. Heart rate and self‐reported exhaustion were registered. Results CPR quality was not different in the two groups: compression depth, 43 mm ± 7 versus 43 ± 4, P = 0.72; compressions rate, 97 min−1 ± 11 versus 93 ± 15, P = 0.26; ventilation rate, 2.4 min−1 ± 1.7 versus 2.8 ± 1.1, P = 0.35; and hands‐off time 273 s ± 50 versus 270 ± 66, P = 0.82; in realistic (n = 31) and traditional (n = 33) groups, respectively. No fatigue was evident in the repeated measures analysis of variance. Work load was not different between the groups; attained percentage of age predicted maximum heart rate, 73% ± 9 and 76 ± 11, P = 0.37, reported exhaustion 43 ± 21 (scale: 0 to 100) and 37 ± 19, P = 0.24. Conclusions Elderly lay people are capable of performing chest compressions with acceptable quality for ten minutes in a realistic cardiac arrest simulation. Ventilation quality and hands‐off time were not adequate in either group.