title: Uninterrupted chest compression CPR is easier to perform and remember than standard CPR.
abstract: BACKGROUND
  It has long been observed that CPR skills rapidly decline regardless of the modality used for teaching or criteria used for testing. Uninterrupted chest compression CPR (UCC-CPR) is a proposed alternative to standard single rescuer CPR (STD-CPR) for laypersons in witnessed unexpected cardiac arrest in adults. It delivers substantially more compressions per minute and may be easier to remember and perform than standard CPR.
  
  
  METHODS
  In this prospective study, 28 medical students were taught STD-CPR and UCC-CPR and then were tested on each method at baseline (0), 6, and 18 months after training. The students' performance for at least 90 s of CPR was evaluated based on video and Laerdal Skillreporter Resusci Anne recordings.
  
  
  RESULTS
  The mean number of correct chest compressions delivered per minute trended down over time in STD-CPR (23 +/- 3, 19 +/- 4 , and 15 +/- 3; P = 0.09) but stayed the same in UCC-CPR (43 +/- 9, 38 +/- 7, and 37 +/- 7 = 0.91) at 0, 6, and 18 months, respectively. The mean percentage of chest compressions delivered correctly fell over time in STD-CPR (54 +/- 6%, 35 +/- 6%, and 32 +/- 6%; P = 0.02) but stayed the same in UCC-CPR (34 +/- 5%, 41 +/- 7%, and 38 +/- 8%) at 0, 6, and 18 months, respectively. The number of chest compressions delivered per minute was higher in UCC-CPR at 0, 6, and 18 months (113 versus 44, P < 0.0001; 94 versus 47, P < 0.0001; and 92 versus 44, P < 0.001). The greater number of chest compressions was due to a mean ventilaroty pause of 13-14 s during STD-CPR at all three time points.
  
  
  CONCLUSIONS
  Chest compression performance during STD-CPR declined in repeated testing over 18 months whereas there was minimal decline in chest compressions performance on repeated testing of UCC-CPR. In addition, substantially more chest compressions were delivered during UCC-CPR compared to STD-CPR at all time points primarily because of long pauses accompanying rescue breathing.
authors.affiliation: Sarver Heart Center, College of Medicine, University of Arizona, 451 W Yucca Ct, #214, Tucson, AZ 85704, USA. josephh@u.arizona.edu
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Heidenreich
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Sanders
authors.forename: Travis A
authors.initials: TA
authors.lastname: Higdon
authors.forename: Karl B
authors.initials: KB
authors.lastname: Kern
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Gordon A
authors.initials: GA
authors.lastname: Ewy
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies