title: Does the quality of chest compressions deteriorate when the chest compression rate is above 120/min?
abstract: OBJECTIVE
  The quality of chest compressions along with defibrillation is the cornerstone of cardiopulmonary resuscitation (CPR), which is known to improve the outcome of cardiac arrest. We aimed to investigate the relationship between the compression rate and other CPR quality parameters including compression depth and recoil.
  
  
  METHODS
  A conventional CPR training for lay rescuers was performed 2 weeks before the 'CPR contest'. CPR anytime training kits were distributed to respective participants for self-training on their own in their own time. The participants were tested for two-person CPR in pairs. The quantitative and qualitative data regarding the quality of CPR were collected from a standardised check list and SkillReporter, and compared by the compression rate.
  
  
  RESULTS
  A total of 161 teams consisting of 322 students, which includes 116 men and 206 women, participated in the CPR contest. The mean depth and rate for chest compression were 49.0±8.2 mm and 110.2±10.2/min. Significantly deeper chest compression depths were noted at rates over 120/min than those at any other rates (47.0±7.4, 48.8±8.4, 52.3±6.7, p=0.008). Chest compression depth was proportional to chest compression rate (r=0.206, p<0.001), but there were significantly more incomplete chest recoils at the rate of over 120/min than at any other rates (9.8%, 6.3%, 25.6%, p=0.011).
  
  
  CONCLUSIONS
  The study showed conflicting results in the quality of chest compression including chest compression depth and chest recoil by chest compression rate. Further evaluation regarding the upper limit of the chest compression rate is needed to ensure complete full chest wall recoil while maintaining an adequate chest compression depth.
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea Department of Emergency Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnamdo, Republic of Korea.
authors.forename: Soo Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
authors.forename: Kyuseok
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
authors.forename: Taeyun
authors.initials: T
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea Department of Emergency Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnamdo, Republic of Korea.
authors.forename: Changwoo
authors.initials: C
authors.lastname: Kang
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
authors.forename: Chanjong
authors.initials: C
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
authors.forename: Joonghee
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
authors.forename: You Hwan
authors.initials: YH
authors.lastname: Jo
authors.affiliation: Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
authors.forename: Joong Eui
authors.initials: JE
authors.lastname: Rhee
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University Hospital, Jinju, Gyeongsangnamdo, Republic of Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008348:Manikins; D011312:Pressure; D012189:Retrospective Studies; D013334:Students; D035441:Thoracic Wall; D055815:Young Adult
keywords: education, methods; guidelines; resuscitation; resuscitation, effectiveness