Fatigue during Chest Compression Using a Neonatal Patient Simulator

Area of Science:

• Neonatal Resuscitation
• Cardiopulmonary Physiology
• Medical Simulation

Background:

• Maintaining high-quality chest compressions (CC) is critical during neonatal resuscitation.
• Operator fatigue can compromise CC effectiveness and patient outcomes.
• Factors influencing fatigue and performance, such as physical fitness and body composition, require further investigation.

Purpose of the Study:

• To evaluate chest compression quality and operator fatigue during simulated neonatal resuscitation.
• To explore the association between CC performance, provider aerobic activity, and body mass index (BMI).

Main Methods:

• Prospective observational experimental study involving healthcare professionals performing 10-minute simulated neonatal CC with ventilation.
• Fatigue was proxied by four consecutive CC below target.
• Aerobic activity participation and BMI were recorded.

Main Results:

• 52% of participants showed signs of fatigue before the 10-minute mark.
• Higher BMI and lack of aerobic activity were significantly associated with earlier fatigue.
• CC performance quality decreased significantly over time, with reduced effectiveness occurring around 7.7 minutes.

Conclusions:

• Chest compression quality deteriorates, and fatigue is prevalent within 10 minutes of simulated neonatal resuscitation.
• Provider fatigue is linked to lower aerobic fitness and higher BMI (≥25).
• Guidelines recommending frequent rotation of CC providers during prolonged neonatal resuscitations are supported by these findings.