Rescuers' physical fatigue with different chest compression to ventilation methods during simulated infant cardiopulmonary resuscitation.

Objective: To assess development of objective, subjective and indirect measures of fatigue during simulated infant cardiopulmonary resuscitation (CPR) with two different methods.

Methods: Using a neonatal manikin, 17 subject-pairs were randomized in a crossover design to provide 5-min CPR with a 3:1 chest compression (CC) to ventilation (C:V) ratio and continuous CCs at a rate of 120 min(-1) with asynchronous ventilations (CCaV-120). We measured participants' changes in heart rate (HR) and mean arterial pressure (MAP); perceived level of fatigue on a validated Likert scale; and manikin CC measures.

Results: CCaV-120 compared with a 3:1 C:V ratio resulted in a change during 5-min of CPR in HR 49 versus 40 bpm (p = 0.01), and MAP 1.7 versus -2.8 mmHg (p = 0.03); fatigue rated on a Likert scale 12.9 versus 11.4 (p = 0.2); and a significant decay in CC depth after 90 s (p = 0.03).

Conclusions: The results indicate a trend toward more fatigue during simulated CPR in CCaV-120 compared to the recommended 3:1 C:V CPR. These results support current guidelines.