title: CPR PRO® device reduces rescuer fatigue during continuous chest compression cardiopulmonary resuscitation: a randomized crossover trial using a manikin model.
abstract: BACKGROUND
  The performance of high-quality chest compressions with minimal interruptions is one of the most important elements of the "Chain of Survival."
  
  
  OBJECTIVE
  To evaluate the impact of a novel CPR PRO(®) (CPRO) device for manual chest compression on rescuer fatigue, pain, and cardiopulmonary resuscitation (CPR) quality.
  
  
  METHODS
  Randomized crossover trial of 24 health care professionals performing continuous chest compression CPR for 10 min with a CPRO device and conventional manual CPR (MCPR). Data about chest compressions were recorded using a manikin. Rescuers' physiologic signs were recorded before and after each session, and heart rate (HR) data were tracked continuously. Fatigue was assessed with ratings of perceived exertion, and pain questionnaire.
  
  
  RESULTS
  All subjects completed 10 min of CPR with both methods. Significantly more rest breaks were taken during MCPR sessions (1.7 ± 2 vs. 0.21 ± 0.72). Subjects' perceived exertion was higher after MCPR, as well as the average (120.7 ± 16.8 vs. 110.8 ± 17.6) and maximal HR (134.3 ± 18.5 vs. 123.42 ± 16.5) during testing. Subjects reported more pain in the hands, especially the wrist, after performing MCPR. Average depth of compressions was higher with the CPRO device (4.6 ± 7.0 vs. 4.3 ± 7.9) and declined more slowly over time. Other CPR quality parameters, such as the correct position and complete release of pressure, were also better for CPRO CPR.
  
  
  CONCLUSIONS
  CPRO device reduces rescuer fatigue and pain during continuous chest compression CPR, which results in a higher quality of CPR in a simulation setting.
authors.affiliation: Institute of Emergency Medicine of Istria County, Emergency Medical Service Pazin, Pazin, Croatia.
authors.forename: Ivor
authors.initials: I
authors.lastname: Kovic
authors.forename: Dinka
authors.initials: D
authors.lastname: Lulic
authors.forename: Ileana
authors.initials: I
authors.lastname: Lulic
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000592:standards; D018592:Cross-Over Studies; D004632:Emergency Medical Services; D005221:Fatigue / Q000517:prevention & control*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000517:prevention & control; D005082:Physical Exertion / Q000502:physiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: European Resuscitation Council guidelines; cardiopulmonary resuscitation; crossover studies; heart arrest; manikins