title: Rescuer fatigue during simulated neonatal cardiopulmonary resuscitation.
abstract: OBJECTIVE
  To assess development of fatigue during chest compressions (CCs) in simulated neonatal cardiopulmonary resuscitation (CPR).
  
  
  METHODS
  Prospective randomized manikin crossover study. Thirty neonatal healthcare professionals who successfully completed the Neonatal Resuscitation Program performed CPR using (i) 3:1 compression:ventilation (C:V) ratio, (ii) continuous CC with asynchronous ventilation (CCaV) at a rate of 90 CC per min and (iii) CCaV at 120 CC per min for a duration of 10 min on a neonatal manikin. Changes in peak pressure (a surrogate of fatigue) and CC rate were continuously recorded and fatigue among groups was compared. Participants were blinded to pressure tracings and asked to rate their level of comfort and fatigue for each CPR trial.
  
  
  RESULTS
  Compared with baseline, a significant decrease in peak pressure was observed after 72, 96 and 156 s in group CCaV-120, CCaV-90 and 3:1 C:V, respectively. CC depth decreased by 50% within the first 3 min during CCaV-120, 30% during CCaV-90 and 20% during 3:1 C:V. Moreover, 3:1 C:V and CCaV were similarly preferred by healthcare professionals.
  
  
  CONCLUSIONS
  Similarly, 3:1 C:V and CCaV CPR were also fatiguing. We recommend that rescuers should switch after every second cycle of heart rate assessment during neonatal CPR.
authors.affiliation: 1] Faculty of Science, McGill University, Montreal, QC, Canada [2] Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada [3] Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
authors.forename: E S
authors.initials: ES
authors.lastname: Li
authors.affiliation: 1] Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada [2] Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Cheung
authors.affiliation: 1] Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada [2] Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
authors.forename: M
authors.initials: M
authors.lastname: O'Reilly
authors.affiliation: 1] Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada [2] Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Aziz
authors.affiliation: 1] Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada [2] Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada [3] Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors.forename: G M
authors.initials: GM
authors.lastname: Schmölzer
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D018592:Cross-Over Studies; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D015931:Intensive Care, Neonatal / Q000379:methods; D008297:Male; D008348:Manikins; D012121:Respiration, Artificial / Q000379:methods*; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D013997:Time Factors