Three-rescuer CPR: the method of choice for firefighter CPR?

To compare the quality of CPR provided by firefighters performing three-rescuer CPR with that achieved by firefighters trained to provide standard two-rescuer CPR.

Eight months after training a large number of firefighters to perform three-rescuer CPR, we used a quasi-experimental design to compare the performance of a randomly selected subset of these companies to that achieved by a control group of engine companies that received refresher training in standard two-rescuer CPR. Both groups used bag-valve masks to provide rescue ventilations. Testing was conducted on a no-notice basis with a recording mannequin. Key actions were scored by an experienced observer using explicit pass-fail criteria. Mannequin-generated strip charts were used to calculate the rate and depth of chest compressions and the ventilatory rate, volume, and minute ventilation in a blinded manner.

Fire stations of the Memphis Fire Department. The department is the sole provider of first-responder emergency care to the citizens of Memphis, Tennessee (population, 610,000).

Three-rescuer teams delivered a mean minute ventilation substantially greater than that produced by two-rescuer teams (7.7 +/- 5.3 L versus 4.9 +/- 4.2 L, P < .001). Intergroup differences in the mean depth of chest compressions were less marked, but they were still significant (17.2 +/- 8.3 mm of recorder-needle deflection versus 13.7 +/- 7.0 mm, P < .001).

Three rescuers can produce better CPR than two when a bag-valve-mask device is used. The technique is easily learned and readily retained.