Cardiopulmonary resuscitation and the 2005 universal algorithm: has the quality of CPR improved?
OBJECTIVE
Chest compressions are crucial in cardiopulmonary resuscitation (CPR), although the optimal number, rate and sequence are unknown. The 2005 CPR guidelines of the European Resuscitation Council (ERC) brought major changes to the basic life support algorithm. One of the major aims of the ERC was to decrease hands-off time in order to improve perfusion of the coronary vessels and the brain. Using a manikin model of basic life support in simulated cardiac arrest, we compared hands-off time and total number of chest compressions according to the guidelines of 2000 and those of 2005.


METHODS
A total of 50 volunteers performed CPR according to the guidelines of 2000 (Group 2000) and 2005 (Group 2005) in a randomized unblinded cross-over study. Volunteers received 10 min of standardized teaching and 10 min of training, including corrective feedback, for each set of guidelines before performing 5 min of basic life support on a manikin. We compared hands-off time as the primary outcome parameter and the total number of chest compressions as the secondary outcome parameter.


RESULTS
Fifty volunteers were enrolled in the study, one individual dropped out after randomization. In Group 2005, hands-off time was significantly lower (mean 107 +/- 19 [SD] s vs. 139 +/- 15 s in Group 2000 (P < 0.0001) and the total number of chest compressions was significantly higher (347 +/- 64 compressions vs. 233 +/- 51 compressions; P < 0.0001).


CONCLUSIONS
In this manikin setting, both hands-off time and the total number of chest compressions improved with basic life support performed according to the ERC guidelines of 2005.
Roessler
Bernhard
B
Department of Anesthesia and General Intensive Care, Medical University of Vienna, Vienna, Austria.
Fleischhackl
Roman
R
Losert
Heidrun
H
Wandaller
Cosima
C
Arrich
Jasmin
J
Mittlboeck
Martina
M
Domanovits
Hans
H
Hoerauf
Kaus
K
D000328:Adult; D000465:Algorithms; D001317:Austria; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000592:standards*; D005260:Female; D006336:Heart Massage / Q000592:standards*; D006801:Humans; D008297:Male; D008348:Manikins; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000592:standards; D012011:Red Cross; D013996:Time and Motion Studies