Push-fast recommendation on performing CPR causes excessive chest compression rates, a manikin model

Area of Science:

• Emergency Medicine
• Cardiopulmonary Resuscitation
• Resuscitation Science

Background:

• Chest compression rate impacts cardiopulmonary resuscitation (CPR) quality.
• High compression rates may increase rescuer workload and fatigue.
• This study investigated the effects of 'push fast' (PF) compression rates versus a standard 100 compressions per minute (100-cpm) rate on CPR performance.

Purpose of the Study:

• To compare the effectiveness of the 'push fast' (PF) technique against a standard 100 compressions per minute (100-cpm) rate for chest compressions during CPR.
• To evaluate the impact of compression rate on CPR quality metrics, including compression depth and effectiveness.
• To assess rescuer fatigue associated with different compression rates.

Main Methods:

• A randomized crossover design was employed.
• Participants performed 5-minute hand-only CPR manikin simulations at two different rates: 100-cpm and PF.
• Participants completed both conditions with a 50-minute rest period in between.

Main Results:

• The PF group achieved higher compression rates (156.8 vs 101.6 cpm) and more total compressions.
• However, the PF group demonstrated a lower percentage of effective compressions (47.7% vs 57.9%) and reduced compression depth (35.6 vs 38.0 mm).
• CPR quality, measured by effective compressions and adequate depth, deteriorated earlier in the PF sessions compared to the 100-cpm sessions.

Conclusions:

• The 'push fast' technique significantly decreased the percentile of effective chest compressions compared to the 100-cpm technique.
• The PF technique showed a trend towards increased rescuer fatigue, leading to earlier decay in CPR quality.
• A standard rate of 100 compressions per minute appears more effective for maintaining CPR quality.