title: Single rescuer exertion using a mechanical resuscitation device: a randomized controlled simulation study.
abstract: OBJECTIVE
  The goal of this experimental study was to investigate rescuer exertion when using "Animax," a manually operated hand-powered mechanical resuscitation device (MRD) for cardiopulmonary resuscitation (CPR), compared to standard basic life support (BLS).
  
  
  METHODS
  This was a prospective, open, randomized, crossover simulation study. After being trained, 80 medical students with substantial knowledge in BLS performed one-rescuer CPR using either the MRD or the standard BLS for 12-minute intervals in random order. The main outcome parameter was the heart rate pressure product (RPP) as an index of cardiac work. Secondary outcome parameters were physical exhaustion quantified by the Borg scale (measurement of perceived exertion), Nine Hole Peg Test (NHPT; measurement of fine motor skills), and capillary lactate concentration during testing.
  
  
  RESULTS
  While no significant difference could be found for the RPP, a significantly increased mean heart rate during the final minute of standard BLS compared to the MRD was found (139 ± 22 beats/min vs. 135 ± 26 beats/min, p = 0.027). By contrast, subjective exertion using the MRD was rated significantly higher on the Borg scale (15.1 ± 2.4 vs. 14.6 ± 2.6, p = 0.027). Mean serum lactate concentration was significantly higher when the MRD was used compared to standard BLS (3.4 ± 1.5 mmol/L vs. 2.1 ± 1.3 mmol/L, p ≤ 0.001).
  
  
  CONCLUSIONS
  Use of the MRD leads to a RPP of the rescuers comparable to standard BLS. These findings suggest that there is no clinically relevant reduction of exertion if this MRD is used by a single rescuer. If this kind of MRD is used for CPR, frequent changeovers with a second rescuer should be considered as the guidelines suggest for standard CPR.
authors.affiliation: Department of Anesthesia, General Intensive Care and Pain Control, Division of Cardiothoracic and Vascular Anesthesia and Intensive Care, Vienna, Austria.
authors.forename: Henrik
authors.initials: H
authors.lastname: Fischer
authors.forename: Bernhard
authors.initials: B
authors.lastname: Zapletal
authors.forename: Stephanie
authors.initials: S
authors.lastname: Neuhold
authors.forename: Kurt
authors.initials: K
authors.lastname: Rützler
authors.forename: Tatjana
authors.initials: T
authors.lastname: Fleck
authors.forename: Sophie
authors.initials: S
authors.lastname: Frantal
authors.forename: Lorenz
authors.initials: L
authors.lastname: Theiler
authors.forename: Dominik
authors.initials: D
authors.lastname: Stumpf
authors.forename: Christof
authors.initials: C
authors.lastname: Havel
authors.forename: Robert
authors.initials: R
authors.lastname: Greif
mesh_terms: D001317:Austria; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000295:instrumentation* / Q000379:methods*; D018592:Cross-Over Studies; D004630:Emergencies; D005221:Fatigue; D005260:Female; D006801:Humans; D008021:Life Support Systems / Q000295:instrumentation*; D008297:Male; D008348:Manikins; D005082:Physical Exertion / Q000502:physiology*; D011446:Prospective Studies; D012016:Reference Values; D018635:Rescue Work; D013337:Students, Medical; D055815:Young Adult