The International Liaison Committee on Resuscitation (ILCOR) guidelines suggest rescuers deliver cardiopulmonary resuscitation (CPR) in cycles of 30 chest compressions and 2 ventilations (30:2) at a rate of 100 compressions per minute with a compression depth of 4-5 cm. Given this increase from the previous CPR cycle of 15:2, there is now also greater emphasis on pushing faster and deeper with minimal interruption. This has led to speculation surrounding rescuer fatigue and compression inefficiency. The purpose of this pilot study was to assess the level of work intensity and fatigue among undergraduate students during simulated CPR, including the quality of chest compressions. Methods: this was an observational pilot study investigating second year undergraduate paramedic students’ fatigue levels and quality of chest compressions following 20 minutes of simulated CPR. Data were collected at baseline and after every 2 minutes until conclusion of twenty minutes. Measurements of work intensity and fatigue included heart rate, rating of perceived exertion (Borg), compression depth and compression frequency. Results: a total of 7 subjects participated (2 male, 5 female), with five students aged 21-25 years. Male subjects showed a significantly slower compression rate when compared to females (108.0 vs 125.6 chest compressions per minute, P=0.006). Heart rate was significantly higher than rest (prior to commencing CPR) after 14 minutes of CPR (P=0.045). Perceived exertion was significantly higher than at rest at 2, 6, 10, 14, and 18 minutes, (P<0.01). Conclusion: this pilot study suggests that high levels of fatigue and perceived exertion are present early when undertaking CPR in a controlled setting, with some fatigue attributed to the faster than recommended chest compression rates.

Introduction Provision of adequate chest compressions remains a standard of care for optimal outcome in cardiopulmonary arrest. Given the recent changes to CPR rates and a greater emphasis on pushing faster and deeper, this has raised questions surrounding rescuer fatigue and efficacy of compressions. While a body of work has been undertaken on previous CPR rates and associated fatigue levels, there is a shortage of literature on the latest CPR rates and associated rescuer fatigue in the hospital and prehospital settings. The objective of this paper was to determine the extent of fatigue associated with CPR in both the hospital and prehospital settings. Design A review of the literature using a variety of medical databases, including Cochrane Database of Systemic Reviews, Ovid MEDLINE, EMBASE, and CINAHL electronic databases. The following MeSH terms were used in the search: CPR fatigue, chest compression, compression depth, out of hospital, in-hospital, prehospital, emergency medical services. Results 21 articles met the inclusion criteria, with three of these papers being from the prehospital setting. Currently, there is low level evidence determining the most appropriate length of time in providing quality chest compression before rescuer fatigue occurs. Overall chest compressions were shallower at least half of the time due to fatigue, and the mean compression rate was found to be higher than recommended. Conclusions The findings of this study suggest that the quality of chest compressions deteriorates soon after commencing CPR, and that high quality prehospital studies are lacking.

Introduction Provision of adequate chest compressions remains a standard of care for optimal outcome in cardiopulmonary arrest. Given the recent changes to CPR rates and a greater emphasis on pushing faster and deeper, this has raised questions surrounding rescuer fatigue and efficacy of compressions. While a body of work has been undertaken on previous CPR rates and associated fatigue levels, there is a shortage of literature on the latest CPR rates and associated rescuer fatigue in the hospital and prehospital settings. The objective of this paper was to determine the extent of fatigue associated with CPR in both the hospital and prehospital settings. Methods A review of the literature using a variety of medical databases, including Cochrane Database of Systemic Reviews, Ovid MEDLINE, EMBASE, and CINAHL electronic databases. The following MeSH terms were used in the search: CPR fatigue, chest compression, compression depth, out of hospital, in-hospital, prehospital, emergency medical services. Results 21 articles met the inclusion criteria, with three of these papers being from the prehospital setting. Currently, there is low level evidence determining the most appropriate length of time in providing quality chest compression before rescuer fatigue occurs. Overall chest compressions were shallower at least half of the time due to fatigue, and the mean compression rate was found to be higher than recommended. Conclusion he findings of this study suggest that the quality of chest compressions deteriorates soon after commencing CPR, and that high quality prehospital studies are lacking.