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Effect of physical fatigue on the quality CPR: a water rescue study of lifeguards

Physical fatigue and quality CPR in a water rescue
Published:October 22, 2012DOI:https://doi.org/10.1016/j.ajem.2012.09.012

      Abstract

      Purpose

      The purpose of the study is to analyze the influence of the fatigue caused by a water rescue on the cardiopulmonary resuscitation (CPR) performance.

      Methods

      The sample of our research is composed of a group of 60 lifeguards (30 men and 30 women) who have been trained at the Universities of A Coruña and Vigo. Two tests were conducted: the first test involved the execution of 5 min of CPR (rested), and the second one in performing water rescue and subsequent CPR (exhausted) for 5 minutes. The quality of the CPR at rest and at fatigue condition was compared. The recording instrument was the Laerdal Resusci Anne manikin. The time of the water rescue was also registered.

      Results

      Gender does not significantly influence CPR, either at rest or at fatigue condition. However, the fatigue caused by rescue has a significant influence on the total quantity of chest compressions: rested (380 ± 38.64); exhausted (411 ± 56.09; P < .001) and ventilations: rested (24 ± 2.97); exhausted (26 ± 3.92; P < .001). Also in correct chest compressions: rested (285 ± 82.67); exhausted (246 ± 122.08; P = .02) and ventilations: rested (14 ± 7.09); exhausted (9 ± 6.67; P < .001). As far as the water rescue is concerned, men are faster (261 ± 34.58 s) when compared to women (326 ± 99.87 seconds; P = .001).

      Conclusion

      The accumulated fatigue during a water rescue performed by lifeguards reduces the quality of chest compressions and ventilations on the CPR.
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      References

        • Claesson A.
        • Karlsson T.
        • Thorén A.
        • Herlitz J.
        Delay and performance of cardiopulmonary resuscitation in surf lifeguards after simulated cardiac arrest due to drowning.
        Am J Emerg Med. 2011; 29: 1044-1050
        • Peden M.
        • Oyegbite K.
        • Ozanne-Smith J.
        • et al.
        World report on child injury prevention.
        Geneva, UNICEF2008
        • MacKay M.
        • Vincenten J.
        Child safety report card 2009: Europe Summary for 24 Countries.
        Amsterdam, European Child Safety Alliance-Eurosafe2009
        • Centers for Disease Control and Prevention - National Center for Injury Prevention and Control
        National Action Plan for Child Injury Prevention.
        CDC-NCIPC, Atlanta2012
        • Venema A.M.
        • Groothoff J.W.
        • Bierens J.
        The role of bystanders during rescue and resuscitation of drowning victims.
        Resuscitation. 2010; 81: 434-439
        • Nolan J.P.
        • Soar J.
        • Zideman D.A.
        • et al.
        European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary..
        Resuscitation. 2010; 81: 1219-1276
        • Koster R.W.
        • Baubin M.A.
        • Bossaert L.L.
        • et al.
        European Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult basic life support and use of automated external defibrillators.
        Resuscitation. 2010; 81: 1277-1292
        • Travers A.H.
        • Rea T.D.
        • Bobrow B.J.
        • et al.
        Part 4: CPR Overview: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitacion and Emergency Cardiovascular Care.
        Circulation. 2010; 122: s676-s684
        • Foo N.
        • Chang J.
        • Lin H.
        • Guo H.
        Rescuer fatigue and cardiopulmonary resuscitation positions: a randomized controlled crossover trial.
        Resuscitation. 2010; 81: 579-584
        • Weisfeldt M.L.
        • Sitlani C.M.
        • Ornato J.P.
        • et al.
        Survival after application of automatic external defibrillators before arrival of the emergency medical system. Evaluation in the resuscitation outcomes consortium population of 21 million.
        J Am Coll Cardiol. 2010; 55: 1713-1720
        • Adelborg K.
        • Dalgas C.
        • Grove E.L.
        • Jørgensen C.
        • Al-Mashhadi R.H.
        • Løfgren B.
        Mouth-to-mouth ventilation is superior to mouth-to-pocket mask and bag-valve-mask ventilation during lifeguard CPR: A randomized study.
        Resuscitation. 2011; 82: 618-622
        • Heidenreich J.W.
        • Bonner A.
        • Sanders A.B.
        Rescuer fatigue in the elderly: standard vs hands-only CPR..
        J Emerg Med. 2012; 42: 88-92
        • Holmberg M.
        • Holmberg S.
        • Herlitz J.
        Effect of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients in Sweden.
        Resuscitation. 2000; 47: 59-70
        • Szpilman D.
        • Soares M.
        In-water resuscitation—is it worthwhile?.
        Resuscitation. 2004; 63: 25-31
        • Perkins G.D.
        In-water resuscitation: a pilot evaluation.
        Resuscitation. 2005; 65: 321-324
        • Soar J.
        • Perkins G.D.
        • Abbas G.
        • et al.
        European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution.
        Resuscitation. 2010; 81: 1400-1433
        • Neset A.
        • Birkenes T.S.
        • Furunes T.
        • et al.
        A randomized trial on elderly laypersons' CPR performance in a realistic cardiac arrest simulation.
        Acta Anaesthesiol Scand. 2012; 56: 124-131
        • Chi C.
        • Tsou J.
        • Su F.
        Effects of compression-to-ventilation ratio on compression force and rescuer fatigue during cardiopulmonary resuscitation.
        Am J Emerg Med. 2010; 28: 1016-1023
        • Riera S.Q.
        • Gonzalez B.S.
        • Álvarez J.T.
        • Fernández M.
        • Saura J.M.
        The physiological effect on rescuers of doing 2 min of uninterrupted chest compressions.
        Resuscitation. 2007; 74: 108-112
        • Ducharme M.B.
        • Lounsbury D.S.
        Self-rescue swimming in cold water: the latest advice.
        Appl Physiol Nutr Metab. 2007; 32: 799-807
        • International Life Saving Federation
        World drowning report.
        Leuven, ILS2007
        • Royal Life Saving Society – Australia
        National drowning report 2011. RLSSA, Australia2011
        • Gulbin J.P.
        • Fell J.W.
        • Gaffney P.T.
        A physiological profile of elite surf ironmen, full time lifeguards and patrolling surf life savers.
        Aust J Sci Med Sport. 1996; 28: 86-90
        • International Life Saving Federation
        Appendix 10: International surf lifeguard. Minimum recommended competencies. ILS, Leuven2000 (Accessed 29 May 2012)
        • Szpilman D.
        • Bierens J.J.L.M.
        • Handley A.J.
        • Orlowski J.P.
        Drowning.
        N Engl J Med. 2012; 366: 2102-2110
        • Wenzel V.
        • Idris A.H.
        • Banner M.J.
        • Kubilis P.S.
        • Williams J.L.
        Influence of tidal volume on the distribution of gas between the lungs and stomach in the no intubated patient receiving positive-pressure ventilation.
        Crit Care Med. 1998; 26: 364-368
        • Russo S.G.
        • Neumann P.
        • Reinhardt S.
        • et al.
        Impact of physical fitness and biometric data on the quality of external chest compression: a randomised, crossover trial.
        Emerg Med. 2011; : 11
        • United States Lifeguard Standards
        An evidence-based review and report by the United States Lifeguard Standards Coalition.
        Int J Aquat Res Educ. 2011; 5: 61-129
        • Peberdy M.A.
        • Silver A.
        • Ornato J.P.
        Effect of caregiver gender, age, and feedback prompts on chest compression rate and depth.
        Resuscitation. 2009; 80: 1169-1174
        • Hong D.Y.
        • Park S.O.
        • Lee K.R.
        • Baek K.J.
        • Shin D.H.
        A different rescuer changing strategy between 30:2 cardiopulmonary resuscitation and hands-only cardiopulmonary resuscitation that considers rescuer factors: a randomized cross-over simulation study with a time-dependent analysis.
        Resuscitation. 2012; 83: 353-359
        • Reilly T.
        • Wooler A.
        • Tipton M.
        Occupational fitness standards for beach lifeguards. Phase 1: the physiological demands of beach lifeguarding.
        Occup Med-Oxford. 2006; 56: 6-11
        • Ochoa F.J.
        • Ramalle-Gómara E.
        • Lisa V.
        • Saralegui I.
        The effect of rescuer fatigue on the quality of chest compressions.
        Resuscitation. 1998; 37: 149-152
        • Lyon R.M.
        • Cobbe S.M.
        • Bradley J.M.
        • Grubb N.R.
        Surviving out of hospital cardiac arrest at home: a postcode lottery?.
        Emerg Med J. 2004; 21: 619-624
        • Herlitz J.
        • Svensson L.
        • Engdahl J.
        • Ängquist K.
        • Silfverstolpe J.
        • Holmberg S.
        Association between interval between call for ambulance and return of spontaneous circulation and survival in out-of-hospital cardiac arrest.
        Resuscitation. 2006; 71: 40-46
        • Claesson A.
        • Svensson L.
        • Silfverstolpe J.
        • Herlitz J.
        Characteristics and outcome among patients suffering out-of-hospital cardiac arrest due to drowning.
        Resuscitation. 2008; 76: 381-387