Effect of 24-h Shifts on Cardiopulmonary Resuscitation Performance and Fatigue: A Simulation-Based Study

High-quality cardiopulmonary resuscitation (CPR) is critical for maintaining effective circulation during cardiac arrest. CPR success depends on uninterrupted, high-quality chest compressions delivered at an appropriate rate and depth. However, whether this performance can be sustained under prolonged working conditions is uncertain.

This simulation-based study evaluated the impact of fatigue developing during 24-h shifts on CPR quality among emergency medicine residents.

This prospective simulation study included 37 emergency medicine residents from two tertiary hospitals. Participants performed CPR on a manikin equipped with feedback devices at 0, 8, 16, and 24 h of a 24-h shift. Each session lasted 10 min and consisted of five 2-min cycles of chest compressions, interspersed with 2-min rest periods. Compression rate, depth, and quality metrics were recorded. Fatigue levels were assessed using the Modified Borg Scale before and after each session.

Mean chest compression rate and depth remained within guideline-recommended ranges at all time points, indicating sustained clinical performance. Although subjective fatigue scores increased significantly and progressively throughout the shift (p < 0.001), this physiological strain did not correlate with a significant decline in CPR quality metrics. While minor statistical fluctuations were observed in compression rate relative to baseline, the group performance consistently met standard resuscitation targets.

Emergency medicine residents maintained guideline-compliant CPR throughout 24-hour shifts despite fatigue. However, implementing fatigue management strategies, including optimized scheduling and structured rest, is recommended for provider and patient safety.