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

Hong, Ming Yuan; Tsou, Jui Yi; Tsao, Pai Chin; Chang, Chih Jan; Hsu, Hui‐Ping; Chan, Tsung Yu; Lin, Sheng Hsiang; Hsien, Chih; Su, Fong-Chin

doi:10.1016/j.ajem.2014.08.074

Cited by 12 publications

(7 citation statements)

References 37 publications

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“…Our DS subjects obtained CC depths comparable to those reported in laypersons after viewing an ultra-brief video 5 and to those reported in other settings by professional subjects. 11 Hong et al 17 in a crossover study comparing 100-cpm to as-fast-as you can observed that subjects from both groups achieved similar CC depth as our DS subjects (38 ± 8 in the 100-cpm group and 35.6 ± 12 mm in the push-fast group).…”

Section: Discussionsupporting

confidence: 65%

Quality of chest compressions by Down syndrome people: A pilot trial

et al. 2015

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Section: Discussionsupporting

confidence: 65%

Quality of chest compressions by Down syndrome people: A pilot trial

et al. 2015

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“…In addition, in an attempt to minimize the effect of rescuer fatigue, we selected a 2-minute time limit for compressions. Furthermore, the importance of rescuer fatigue was highlighted by Hong et al 17 to substantially diminish the quality of CPR as early as the third minute of continuous chest compressions. These outcomes support the pediatric advanced life support concept of "push-as-fast-as-you-can" to emphasize organization of care around 2-minute periods of uninterrupted CPR.…”

Section: Discussionmentioning

confidence: 99%

Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

et al. 2015

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Determine whether the use of a metronome improves chest compression rate and depth during cardiopulmonary resuscitation (CPR) on a pediatric manikin.METHODS: A prospective, simulation-based, crossover, randomized controlled trial was conducted. Participants included pediatric residents, fellows, nurses, and medical students who were randomly assigned to perform chest compressions on a pediatric manikin with and without an audible metronome. Each participant performed 2 rounds of 2 minutes of chest compressions separated by a 15-minute break.RESULTS: A total of 155 participants performed 2 rounds of chest compressions (74 with the metronome on during the first round and 81 with the metronome on during the second round of CPR). There was a significant improvement in the mean percentage of compressions delivered within an adequate rate (90-100 compressions per minute) with the metronome on compared with off (72% vs 50%; mean difference [MD] 22%; 95% confidence interval [CI], 15% to 29%). No significant difference was noted in the mean percentage of compressions within acceptable depth (38-51 mm) (72% vs 70%; MD 2%; 95% CI, 22% to 6%). The metronome had a larger effect among medical students (73% vs 55%; MD 18%; 95% CI, 8% to 28%) and pediatric residents and fellows (84% vs 48%; MD 37%; 95% CI, 27% to 46%) but not among pediatric nurses (46% vs 48%; MD 23%; 95% CI, 219% to 14%). CONCLUSIONS:The rate of chest compressions during CPR can be optimized by the use of a metronome. These findings will help medical professionals comply with the American Heart Association guidelines. WHAT'S KNOWN ON THIS SUBJECT:The frequency of cardiac arrest is significantly lower in children than in adults, rendering the delivery of high-quality cardiopulmonary resuscitation more difficult. Metronome-based studies in adults showed improvement in adequate compression rate, with a detrimental effect on the depth of chest compressions. WHAT THIS STUDY ADDS:This is the first pediatric study to confirm that the use of a metronome during cardiopulmonary resuscitation significantly improves the delivery of adequate rate without affecting the compression depth. This effect was more prominent among medical students and pediatric residents and fellows than nurses. Dr Zimmerman conceptualized and designed the study, coordinated and supervised data collection, carried out the initial analysis, and drafted the initial manuscript; Dr Cohen coordinated and supervised data collection, carried out the initial analysis, and drafted the initial manuscript; Drs Maniaci, Pena, and Linares carried out initial analysis and reviewed and revised the manuscript; Dr Lozano provided statistical advice on the study design, carried out initial analysis, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.This trial has been registered at www.clinicaltrials.gov (identifier NCT02511470). 4 Poor-quality cardiopulmonary resuscitation (CPR) has been cited as a contributing factor to this dismal statistic on outcomes. 4 Optim...

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“…Different curricula of education can result in different CPR performance of trainees, and the study of Hong and colleagues reflected this fact well. The '100 compression rate' recommended group performed compressions at a mean rate of 101.6/min during the 5 min CPR, whereas the 'push-faster' technique group showed a mean compression rate of 156.8 compressions per minute [19]. Currently, it may not be easy to decide which method is optimal to enhance rescuer performance and contribute toward improved survival of arrest victims.…”

Section: Discussionmentioning

confidence: 92%