Rescuer Fatigue During CPR Clinical Trial
Official title:
Effect of Rescuer Fatigue on Chest Compression Effectiveness
This prospective, randomized experimental trial to determine whether the quality of healthcare provider/rescuer chest compressions (CC) deteriorates at the same rate in pediatric models as compared to adult models. To determine the relationship between physiologic/metabolic markers of work in rescuers and chest compression deterioration, and to determine the effect of stepstool use on the quality of chest compressions and metabolic demand. To determine whether the quality of chest compressions deteriorates at the same rate in participants using a stepstool compared to those not using a stepstool.
Context:
Pediatric cardiac arrests result in poor outcomes. Effective chest compressions improve
survival in such patients. Unfortunately, compressions are generally inadequately performed
and the quality of compressions given deteriorates rapidly with time. Current American Heart
Association (AHA) guidelines call for faster and deeper chest compressions with minimization
of interruptions. The effect of fatigue on operational performance while adhering strictly
to these AHA guidelines is unknown. In addition, there is little pediatric data on rescuer
fatigue and chest compression deterioration. Also, the use of a stepstool may affect the
quality of chest compressions and may also have an impact on the fatigue of the rescuer.
Understanding the biomechanics during optimal chest compression performance may prove useful
in the recommendations of conditions and equipment for execution of more effective chest
compressions during a cardiac arrest. We will aim to observe and understand the
biomechanical qualities that allow for the most effective compressions.
Objectives:
1. To determine whether the quality of chest compressions deteriorates at the same rate in
pediatric models as compared to adult models. To determine the relationship between
physiologic/metabolic markers of work in rescuers and chest compression deterioration.
2. To determine the effect of stepstool use on the quality of chest compressions and
metabolic demand. To determine whether the quality of chest compressions deteriorates
at the same rate in participants using a stepstool compared to those not using a
stepstool.
Study Design/Setting/Participants:
This prospective, randomized experimental trial will be performed at the Children's Hospital
of Philadelphia. Participants will be healthcare practitioners who routinely provide chest
compressions in the course of their work. Lay practitioners will be excluded.
Study Measures:
Participants will be asked to perform continuous chest compressions on pediatric and adult
sized manikins. Compression rate, depth, applied force as well as participant physiologic
work efficiency and anaerobic threshold will be recorded. To evaluate the second objective,
a new cohort of participants will perform continuous chest compressions on an adult sized
manikin with and without a stepstool.. Compression rate, depth, applied force as well as
participant physiologic work efficiency and anaerobic threshold will also be recorded.
Videotaping of each subject will also be used for comparison of subjective assessment of
chest compression quality and objective chest compression quality data.
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Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic