Assessing the quality of CPR performed by a single lifeguard, two lifeguards and a lifeguard with a bystander after water rescue: a quasi-experimental trial.


Journal

Emergency medicine journal : EMJ
ISSN: 1472-0213
Titre abrégé: Emerg Med J
Pays: England
ID NLM: 100963089

Informations de publication

Date de publication:
May 2020
Historique:
received: 29 06 2018
revised: 28 12 2019
accepted: 01 01 2020
pubmed: 24 3 2020
medline: 23 1 2021
entrez: 24 3 2020
Statut: ppublish

Résumé

High-quality cardiopulmonary resuscitation (CPR) could improve survival of drowning victims. The purpose of the study is to assess the impact of fatigue caused by water rescue on subsequent CPR quality and the influence of a bystander's participation on CPR quality in a lifeguard rescue. This was a simulated quasi-experimental study with a sample of 14 lifeguards and 13 laypersons. Each lifeguard performed 2 min single-rescuer CPR as baseline measurement. In three separate trials, a single lifeguard swam 50 m to perform a water rescue in a pool and returned with the manikin another 50 m. After each rescue, 10 min of CPR was performed by a single lifeguard, two lifeguards or a lifeguard with a layperson with no CPR training. Paired t-test and repeated analysis of variance were used to analyse CPR quality variables. Baseline CPR quality was adequate for most measures except compression depth and re-expansion. After water rescue, the single lifeguard trial showed no significant differences compared with baseline. CPR score and ventilation score of the single-lifeguard trial was higher than that of the lifeguard-bystander trial (p=0.027, p<0.001). Both the two-lifeguard trial (p=0.025), and lifeguard-bystander trial (p=0.010) had a lower percentage of breaths with correct ventilation volume and higher percentage of breaths with excessive ventilation volume (p=0.007, p=0.011, respectively) than the single-lifeguard trial. No-flow time of the lifeguard-bystander trial was longer than other trials (p<0.001). Although CPR given by the lifeguard was not optimal, fatigue generated by a water rescue has no impact on the quality of subsequent CPR performed by a trained lifeguard for 10 min. Untrained bystanders assisting in CPR in a drowning event is unlikely to be helpful.

Sections du résumé

BACKGROUND BACKGROUND
High-quality cardiopulmonary resuscitation (CPR) could improve survival of drowning victims. The purpose of the study is to assess the impact of fatigue caused by water rescue on subsequent CPR quality and the influence of a bystander's participation on CPR quality in a lifeguard rescue.
METHODS METHODS
This was a simulated quasi-experimental study with a sample of 14 lifeguards and 13 laypersons. Each lifeguard performed 2 min single-rescuer CPR as baseline measurement. In three separate trials, a single lifeguard swam 50 m to perform a water rescue in a pool and returned with the manikin another 50 m. After each rescue, 10 min of CPR was performed by a single lifeguard, two lifeguards or a lifeguard with a layperson with no CPR training. Paired t-test and repeated analysis of variance were used to analyse CPR quality variables.
RESULTS RESULTS
Baseline CPR quality was adequate for most measures except compression depth and re-expansion. After water rescue, the single lifeguard trial showed no significant differences compared with baseline. CPR score and ventilation score of the single-lifeguard trial was higher than that of the lifeguard-bystander trial (p=0.027, p<0.001). Both the two-lifeguard trial (p=0.025), and lifeguard-bystander trial (p=0.010) had a lower percentage of breaths with correct ventilation volume and higher percentage of breaths with excessive ventilation volume (p=0.007, p=0.011, respectively) than the single-lifeguard trial. No-flow time of the lifeguard-bystander trial was longer than other trials (p<0.001).
CONCLUSIONS CONCLUSIONS
Although CPR given by the lifeguard was not optimal, fatigue generated by a water rescue has no impact on the quality of subsequent CPR performed by a trained lifeguard for 10 min. Untrained bystanders assisting in CPR in a drowning event is unlikely to be helpful.

Identifiants

pubmed: 32201378
pii: emermed-2018-207939
doi: 10.1136/emermed-2018-207939
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

306-313

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Shuang Li (S)

Emergency Nursing Department, Second Military Medical University Department of Nursing Science, Shanghai, China.

Ting Kan (T)

Second Medical Center, General Hospital of People's Liberation Army, Beijing, Beijing, China.

Zijian Guo (Z)

Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.

Chulin Chen (C)

Emergency Nursing Department, Second Military Medical University Department of Nursing Science, Shanghai, China.

Li Gui (L)

Emergency Nursing Department, Second Military Medical University Department of Nursing Science, Shanghai, China shiny0820@163.com.

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