The impact of chest compression rates on quality of chest compressions – A manikin study

• Published in: Resuscitation 2012-03, Vol.83 (3), p.360-364
• Main Authors: Field, Richard A, Soar, Jasmeet, Davies, Robin P, Akhtar, Naheed, Perkins, Gavin D
• Format: Article
• Language: English
• Subjects: Analysis of Variance; Basic life support; Cardiac arrest; Cardiopulmonary resuscitation (CPR); Chest compressions; Cross-Over Studies; Emergency; Heart Massage - standards; Humans; Manikins; Professional Competence; Quality; Statistics, Nonparametric
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2011.07.012

Abstract Purpose Chest compressions are often performed at a variable rate during cardiopulmonary resuscitation (CPR). The effect of compression rate on other chest compression quality variables (compression depth, duty-cycle, leaning, performance decay over time) is unknown. This randomised controlled cross-over manikin study examined the effect of different compression rates on the other chest compression quality variables. Methods Twenty healthcare professionals performed 2 min of continuous compressions on an instrumented manikin at rates of 80, 100, 120, 140 and 160 min−1 in a random order. An electronic metronome was used to guide compression rate. Compression data were analysed by repeated measures ANOVA and are presented as mean (SD). Non-parametric data was analysed by Friedman test. Results At faster compression rates there were significant improvements in the number of compressions delivered (160(2) at 80 min−1 vs. 312(13) compressions at 160 min−1 , P < 0.001); and compression duty-cycle (43(6)% at 80 min−1 vs. 50(7)% at 160 min−1 , P < 0.001). This was at the cost of a significant reduction in compression depth (39.5(10) mm at 80 min−1 vs. 34.5(11) mm at 160 min−1 , P < 0.001); and earlier decay in compression quality (median decay point 120 s at 80 min−1 vs. 40 s at 160 min−1 , P < 0.001). Additionally not all participants achieved the target rate (100% at 80 min−1 vs. 70% at 160 min−1 ). Rates above 120 min−1 had the greatest impact on reducing chest compression quality. Conclusions For Guidelines 2005 trained rescuers, a chest compression rate of 100–120 min−1 for 2 min is feasible whilst maintaining adequate chest compression quality in terms of depth, duty-cycle, leaning, and decay in compression performance. Further studies are needed to assess the impact of the Guidelines 2010 recommendation for deeper and faster chest compressions.