Influence of Physical Activity of the Rescuer on Chest Compression Duration and its Effects on Hemodynamics and Fatigue Levels of the Rescuer: A Simulation-based Study
Varun R Nayak, Akhila Babu, Ramesh Unnikrishnan, Abraham Samuel Babu, Handattu Mahabaleswara Krishna
Citation Information :
Nayak VR, Babu A, Unnikrishnan R, Babu AS, Krishna HM. Influence of Physical Activity of the Rescuer on Chest Compression Duration and its Effects on Hemodynamics and Fatigue Levels of the Rescuer: A Simulation-based Study. Indian J Crit Care Med 2020; 24 (6):409-413.
Background: Cardiopulmonary resuscitation (CPR) is a lifesaving skill performed during the cardiac arrest. Various factors of rescuer affect CPR quality, and rescuers physical fitness is one among the important factors needs to be explored for improved CPR quality. This study aimed to assess the physical activity (PA) levels of the health care providers (HCPs) who were trained in basic life support (BLS) and its relationship on chest compression duration, hemodynamic parameters, and fatigue levels of the rescuers. Materials and methods: A single-center, cross-sectional study was conducted on 48 HCPs who were trained in BLS within one year. Eligible participants were contacted by email, and the responders’ level of PA was determined using the global physical activity questionnaire (GPAQ). The participants were recruited for chest compression-only cardiac arrest scenarios. Each subject performed continuous chest compression on the manikin until they perceived maximum fatigue. Heart rate (HR), blood pressure (BP), oxygen saturation (SpO2), and fatigue level were assessed at baseline, immediately after and following two minutes of cessation of chest compressions. The total duration of chest compression was also documented. Results: Most participants (24, 50%) reported high levels of PA while 22 (45.83%) and 2 (4.17%) reported moderate and low intensity of PA, respectively. The mean age of the 35 participants was 26.08 ± 4.60 years. The mean duration of chest compressions was 193.25 seconds with higher times reported for those with high PA when compared to those with moderate PA (p = 0.017). Similar findings were also observed for fatigue. Conclusion: Rescuers who reported high PA had lower levels of fatigue and could perform longer duration of chest compressions.
Okonta K, Okoh BN. Theoretical knowledge of cardiopulmonary resuscitation among clinical medical students in the university of Port Harcourt, Nigeria. African J Med Heal Sci 2015;14(1):42. DOI: 10.4103/2384-5589.153391.
Hightower D, Thomas SH, Stone CK, Dunn K, March JA. Decay in quality of closed-chest compressions over time. Ann Emerg Med 1995;26(3):300–303. DOI: 10.1016/s0196-0644(95)70076-5.
Monica EK, Erin EB, Zachary DG, Robert AS. AHA guidelines update for CPR and ECC. Circ. Ahajournals 2015. 1–14.
Edelson DP, Abella BS, Kramer-Johansen J, Wik L, Myklebust H, Barry AM, et al. Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest. Resuscitation 2006;71(2):137–145. DOI: 10.1016/j.resuscitation.2006.04.008.
Kramer-Johansen J, Myklebust H, Wik L, Fellows B, Svensson L, Sørebø H, et al. Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study. Resuscitation 2006;71(3):283–292. DOI: 10.1016/j.resuscitation.2006.05.011.
Ochoa FJ, Ramalle-Gómara E, Lisa V, Saralegui I. The effect of rescuer fatigue on the quality of chest compressions. Resuscitation 1998;37(3):149–152. DOI: 10.1016/s0300-9572(98)00057-4.
Ock SM, Kim YM, Chung JH, Kim SH. Influence of physical fitness on the performance of 5-minute continuous chest compression. Eur J Emerg Med 2011;18(5):251–256. DOI: 10.1097/MEJ.0b013e328345340f.
Choi H, Lee HJ, Jeong E, Lee CC, Kim HJ, Singer AJ. iMedPub journals an observational study on importance of CPR provider medical safety: hemodynamic changes and fatigue in young healthy adults after multiple cycles of CPR abstract. 2016. 4–8.
Abelairas-Gómez C, Barcala-Furelos R, Szarpak Ł, García-García Ó, Paz-Domínguez Á, López-García S, et al. The effect of strength training on quality of prolonged basic cardiopulmonary resuscitation. Kardiol Pol 2017;75(1):21–27. DOI: 10.5603/KP.a2016.0165.
Charles P, Adam A, Stephen P, De'ann M, David B. Abstract P168: early markers of rescuer's fatigue. Circulation [Internet] 2009;120(suppl_18):S1478–S1478.
Ashton A, McCluskey A, Gwinnutt CL, Keenan AM. Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min. Resuscitation 2002;55(2):151–155. DOI: 10.1016/s0300-9572(02)00168-5.
Colbert LH, Matthews CE, Schoeller DA, Havighurst TC, Kim K. Intensity of physical activity in the energy expenditure of older adults. J Aging Phys Act 2014;22(4):571–577. DOI: 10.1123/japa.2012-0257.
Lucía A, de las Heras JF, Pérez M, Elvira JC, Carvajal A, Álvarez AJ, et al. The importance of physical fitness in the performance of adequate cardiopulmonary resuscitation. Chest 1999;115(1):158–164. DOI: 10.1378/chest.115.1.158.
Riera SQ, González BS, Álvarez JT, Fernández M, del MF, Saura JM. The physiological effect on rescuers of doing 2 min of uninterrupted chest compressions. Resuscitation 2007;74(1):108–112. DOI: 10.1016/j.resuscitation.2006.10.031.
Wiinberg N, Høegholm A, Christensen HR, Bang LE, Mikkelsen KL, Nielsen PE, et al. 24-h ambulatory blood pressure in 352 normal danish subjects, related to age and gender. Am J Hypertens 1995;8(10 Pt 1):978–986. DOI: 10.1016/0895-7061(95)00216-2.
Reckelhoff JF. Gender differences in the regulation of blood pressure. J Am Heart Assoc 2001;37(5):1199–1208. DOI: 10.1161/01.hyp.37. 5.1199.
Aufderheide TP, Pirrallo RG, Yannopoulos D, Klein JP, von Briesen C, Sparks CW, et al. Incomplete chest wall decompression: a clinical evaluation of CPR performance by trained laypersons and an assessment of alternative manual chest compression-decompression techniques. Resuscitation 2006;71(3):341–351. DOI: 10.1016/j.resuscitation.2006.03.021.
Tanaka S, Tsukigase K, Hara T, Sagisaka R, Myklebust H, Birkenes TS, et al. Effect of real-time visual feedback device “quality cardiopulmonary resuscitation (QCPR) classroom” with a metronome sound on layperson CPR training in Japan: a cluster randomized control trial. BMJ Open 2019;9(6). DOI: 10.1136/bmjopen-2018-026140.
McDonald CH, Heggie J, Jones CM, Thorne CJ, Hulme J. Rescuer fatigue under the 2010 ERC guidelines, and its effect on cardiopulmonary resuscitation (CPR) performance. Emerg Med J 2013;30(8):623–627. DOI: 10.1136/emermed-2012-201610.
Lopez-Gonzalez A, Sanchez-Lopez M, Garcia-Hermoso A, Lopez-Tendero J, Rabanales-Sotos J, Martinez-Vizcaino V. Muscular fitness as a mediator of quality cardiopulmonary resuscitation. Am J Emerg Med 2016;34(9):1845–1849. DOI: 10.1016/j.ajem.2016.06.058.