title: Improving the effectiveness of continuous closed chest compressions: an exploratory study.
abstract: This study was carried out to establish the length of time over which an individual can maintain effective chest compressions and the most effective pattern of rest and handover among a team. The continuing effectiveness of chest compressions was compared between groups of 2 or 3 rescuers performing chest compressions for 1, 2 or 3 min during scenarios lasting 18 min. Evaluation of the effectiveness of compressions was achieved using a computerised resuscitation manikin (Laerdal/Skillmeter) on a hospital trolley. Twenty-one volunteers competent in basic life support participated. The results were analysed using one-way analysis of variance and Dunnett's contrast of the various scenarios. The results demonstrated that a three person team delivering 1 min periods of chest compressions in rotation is significantly better than other sequences at 5 min and beyond (P<0.0001). At 18 min 91.5% of all chest compressions delivered by this three person team were greater than 70% effective. There was no significant difference between the first and final set of chest compressions.
  
  
  CONCLUSIONS
  Continuous chest compressions performed for 1 min, preferably by three rescuers in rotation, maintain a high level of effectiveness. Longer periods of chest compressions should be discouraged.
authors.affiliation: Accident and Emergency, St. Peter's Hospital (Chertsey), 42 Beechcroft Avenue, New Malden, Surrey KT3 3EE, UK. turansev@btinternet.com
authors.forename: Turan S
authors.initials: TS
authors.lastname: Huseyin
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Matthews
authors.forename: Paul
authors.initials: P
authors.lastname: Wills
authors.forename: Vincent M
authors.initials: VM
authors.lastname: O'Neill
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D008297:Male; D010348:Patient Care Team; D013997:Time Factors