Bystander Fatigue and CPR Quality

CJEM Infographic: Bystander Fatigue and CPR Quality by Older Adults

In Infographics, Medical Concepts by Simon HuangLeave a Comment

This month CanadiEM is featuring an article from the Canadian Journal of Emergency Medicine (CJEM) that compares the effectiveness of the continuous chest compression (CCC) and 30:2 compressions to ventilation (30:2) methods of CPR in an older bystander population. Considering that most cardiac arrests occur at home where both the victim and bystander (spouse) are aged in their sixties, there is merit in evaluating these two methods in terms of fatigue and CPR quality for this population.

To compare these two methods, Liu et al. 1 conducted a randomized crossover trial with 59 participants over the age of 55 who were physically capable of performing CPR. Study participants were instructed on both methods of CPR and allowed to practice for 5 minutes with feedback, prior to being randomized to the CCC or 30:2 CPR method. Each group performed 5 minutes of CPR with their assigned method before resting and performing a second 5-minute session of CPR with the other method. Baseline fatigue and physiological parameters (HR, BP) were measured before and after each CPR session, while CPR quality (number and depth of compressions) was assessed using monitors attached to each simulation manikin. In addition to this, each participant was asked which method of CPR they preferred after their second CPR session.

The results of the study showed a mixed picture regarding the two methods of CPR. CCC-CPR was found to produce more compressions of adequate chest depth, but was associated with a quicker decline in chest compression quality over time. Similarly, 69% of participants preferred the 30:2 method of CPR, despite similar levels of fatigue. Overall, this study tentatively suggests that CCC-CPR provides better quality CPR for the first few minutes, however more study is needed to draw definitive conclusions.

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Liu S, Vaillancourt C, Kasaboski A, Taljaard M. Bystander fatigue and CPR quality by older bystanders: a randomized crossover trial comparing continuous chest compressions and 30:2 compressions to ventilations. CJEM. 2016;18(6):461-468. [PubMed]
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Simon Huang

Simon Huang

Simon Huang is a PGY1 FRCP-EM resident at Dalhousie University. He is the Associate Social Media Editor for CJEM and is involved with infographic creation for the CanadiEM website.
Simon Huang
- 2 years ago