Rescuer fatigue in the elderly: standard vs. hands-only CPR

Hands-only cardiopulmonary resuscitation (HO-CPR) is recommended as an alternative to standard CPR (STD-CPR). Studies have shown a degradation of adequate compressions with HO-CPR after 2 min when performed by young, healthy medical students. Elderly rescuers' ability to maintain an adequate compression rate and depth until emergency medical services (EMS) arrives is unknown.

The specific aim of this study was to compare elderly rescuers' ability to maintain adequate compression rate and depth during HO-CPR and STD-CPR in a manikin model.

In this prospective, randomized crossover study, 17 elderly volunteers performed both HO-CPR and STD-CPR, separated by at least 2 days, on a manikin model for 9 min each. The primary endpoint was the number of adequate chest compressions (> 38 mm) delivered per minute. Secondary endpoints were total compressions, compression rate, and the number of breaks taken for rest.

There was no difference in the number of adequate compressions between groups in the first minute; however, the STD-CPR group delivered significantly more adequate chest compressions in minutes 2-9 (p<0.05). The total number of compressions delivered was significantly greater in the HO-CPR than STD-CPR group when considering the entire resuscitation period. A significantly greater number of rescuers took breaks for rest during HO-CPR than STD-CPR.

Although HO-CPR resulted in a greater number of overall compressions than STD-CPR, STD-CPR resulted in a greater number of adequate compressions in all but the first minute of resuscitation.