Fallaha, Jon F., Spooner, Brendan B. and Perkins, Gavin D.. (2009) Does dual operator CPR help minimize interruptions in chest compressions? Resuscitation, Vol.80 (No.9). pp. 1011-1014. ISSN 0300-9572

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Abstract

Aims: Basic Life Support Guidelines 2005 emphasise the importance of reducing interruptions in chest compressions (no-flow duration) yet at the same time stopped recommending Dual Operator CPR. Dual Operator CPR (where one rescuer does ventilations and one chest compressions) could potentially minimize no-flow duration compared to Single Operator CPR. This study aims to determine if Dual Operator CPR reduces no-flow duration compared to Single Operator CPR. Methodology: This was a prospective randomised controlled crossover trial. Medical students were randomised into 'Dual Operator' or 'Single Operator' CPR groups. Both groups performed 4 min of CPR according to their group allocation on a resuscitation manikin before crossing over to perform the other technique one week later. Results: Fifty participants were recruited. Dual Operator CPR achieved slightly lower no-flow durations than the Single Operator CPR (28.5% (S.D. = 3.7) versus 31.6% (S.D. = 3.6), P <= 0.001). Dual Operator CPR was associated with slightly more rescue breaths per minute (4.9 (S.D. = 0.5) versus 4.5 (S.D. = 0.5), P = 0.009. There was no difference in compression depth, compression rate, duty cycle, rescue breath flow rate or rescue breath volume. Conclusions: Dual Operator CPR with a compression to ventilation rate of 30: 2 provides marginal improvement in no-flow duration but CPR quality is otherwise equivalent to Single Operator CPR. There seems little advantage to adding teaching on Dual Operator CPR to lay/trained first responder CPR programs.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	CPR (First aid) -- Methodology, CPR (First aid) -- Study and teaching
Journal or Publication Title:	Resuscitation
Publisher:	Elsevier Ireland Ltd
ISSN:	0300-9572
Date:	September 2009
Volume:	Vol.80
Number:	No.9
Number of Pages:	4
Page Range:	pp. 1011-1014
Identification Number:	10.1016/j.resuscitation.2009.04.048
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Resuscitation Council (UK), National Institute for Health Research (Great Britain) (NIHR)
References:	1. Hightower D, Thomas SH, Stone CK, Dunn K, March JA. Decay in quality of closed-chest compressions over time. AnnEmergMed 1995;26:300-3. 2. Perkins GD, Augre C, Rogers H, Allan M, Thickett DR. CPREzy: an evaluation during simulated cardiac arrest on a hospital bed. Resuscitation 2005;64:103-8. 3. Ochoa FJ, Ramalle-Gomara E, Lisa V, Saralegui I. The effect of rescuer fatigue on the quality of chest compressions. Resuscitation 1998;37:149-52. 4. Handley AJ, Handley JA. Performing chest compressions in a confined space. Resuscitation 2004;61:55-61. 5. Handley AJ, Monsieurs KG, Bossaert LL. European Resuscitation Council Guidelines 2000 for Adult Basic Life Support. A statement from the Basic Life Support and Automated External Defibrillation Working Group(1) and approved by the Executive Committee of the European Resuscitation Council. Resuscitation 2001;48:199-205. 6. Handley AJ, Koster R, Monsieurs K, Perkins GD, Davies S, Bossaert L. European Resuscitation Council guidelines for resuscitation 2005. Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 2005;67 Suppl 1:S7-23. 7. Hackman BB, Kellermann AL, Everitt P, Carpenter L. Three-rescuer CPR: the method of choice for firefighter CPR? Ann Emerg Med 1995;26:25-30. 8. Dunkley CJ, Thomas AN, Taylor RJ, Perkins RJ. A comparison of standard and a modified method of two resuscitator adult cardiopulmonary resuscitation: description of a new system for research into advanced life support skills. Resuscitation 1998;38:7-12. 9. Spooner BB, Fallaha JF, Kocierz L, Smith CM, Smith SC, Perkins GD. An evaluation of objective feedback in basic life support (BLS) training. Resuscitation 2007;73:417-24. 10. Perkins GD, Hulme J, Bion JF. Peer-led resuscitation training for healthcare students: a randomised controlled study. Intensive Care Med 2002;28:698-700. 11. Bucknall V, Sobic EM, Wood HL, Howlett SC, Taylor R, Perkins GD. Peer assessment of resuscitation skills. Resuscitation 2008;77:211-5. 12. Kramer-Johansen J, Edelson DP, Losert H, Kohler K, Abella BS. Uniform reporting of measured quality of cardiopulmonary resuscitation (CPR). Resuscitation 2007;74:406-17. 13. Edelson DP, Litzinger B, Arora V, et al. Resuscitation with actual performance integrated debriefing (RAPID) improves CPR quality and initial patient survival. Resuscitation Science Symposium 2008;A61:29. 14. Edelson DP, Abella BS, Kramer-Johansen J, et al. Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest. Resuscitation 2006;71:137-45. 15. Leary M, Abella BS. The challenge of CPR quality: improvement in the real world. Resuscitation 2008;77:1-3. 16. Eftestol T, Sunde K, Steen PA. Effects of interrupting precordial compressions on the calculated probability of defibrillation success during out-of-hospital cardiac arrest. Circulation 2002;105:2270-3. 17. Valenzuela TD, Kern KB, Clark LL, et al. Interruptions of chest compressions during emergency medical systems resuscitation. Circulation 2005;112:1259-65. 18. Wik L, Kramer-Johansen J, Myklebust H, et al. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA: The Journal of the American Medical Association 2005;293:299-304. 19. Nolan J. European Resuscitation Council Guidelines for Resuscitation 2005: Section 1. Introduction. Resuscitation 2005;67:S3-S6. 20. Perkins GD, Boyle W, Bridgestock H, et al. Quality of CPR during advanced resuscitation training. Resuscitation 2008;77:69-74.
URI:	http://wrap.warwick.ac.uk/id/eprint/16701

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