Acute muscle fatigue and CPR quality assisted by visual feedback devices: A randomized-crossover simulation trial

Area of Science:

• Emergency Medicine
• Physiology
• Biomedical Engineering

Background:

• Cardiopulmonary resuscitation (CPR) is a critical intervention for cardiac arrest.
• Assessing rescuer fatigue is vital for maintaining CPR quality.
• Compression-only CPR (CO-CPR) is an alternative to standard CPR (S-CPR).

Purpose of the Study:

• To analyze acute muscular fatigue (AMF) in triceps brachii and rectus abdominis during CO-CPR versus S-CPR.
• To evaluate the impact of ventilation methods on fatigue and CPR quality.
• To determine the role of prior feedback device training on CPR performance.

Main Methods:

• 18 certified basic life support providers performed 10-minute CO-CPR and S-CPR tests.
• AMF was measured using tensiomyography in triceps brachii or rectus abdominis.
• Ventilation methods (mouth-to-mouth, pocket-mask, bag-valve-mask) were participant-chosen; CPR feedback was constant.

Main Results:

• Rectus abdominis contraction time increased significantly by the fifth CPR period (p=0.020).
• Triceps brachii experienced lower radial muscle belly displacement (p=0.047) and contraction velocity (p=0.018) during CO-CPR compared to S-CPR.
• Prior training with feedback devices correlated with better CPR quality; bag-valve-mask ventilation yielded lower quality.

Conclusions:

• CO-CPR leads to greater AMF than S-CPR, particularly in prolonged efforts.
• Fatigue significantly increases in the later stages of CPR, irrespective of the technique.
• Effective rescuer strength is crucial for utilizing CPR feedback devices; ventilation quality requires enhanced training focus.