title: Push-fast recommendation on performing CPR causes excessive chest compression rates, a manikin model.
abstract: BACKGROUND
  Increasing chest compression rate during cardiopulmonary resuscitation can affect the workload and, ultimately, the quality of chest compression. This study examines the effects of compression at the rate of as-fast-as-you-can on cardiopulmonary resuscitation (CPR) performance.
  
  
  METHODS
  A crossover, randomized-to-order design was used. Each participant performed chest compressions without ventilation on a manikin with 2 compression rates: 100 per minute (100-cpm) and "push as-fast-as you-can" (PF). The participants performed chest compressions at a rate of either 100-cpm or PF and subsequently switched to the other after a 50-minute rest.
  
  
  RESULTS
  Forty-two CPR-qualified nonprofessionals voluntarily participated in the study. During the PF session, the rescuers performed CPR with higher compression rates (156.8 vs 101.6 cpm), more compressions (787.2 vs 510.8 per 5 minutes), and more duty cycles (51.0% vs 41.7%), but a lower percentage of effective compressions (47.7% vs 57.9%) and a lower compression depth (35.6 vs 38.0 mm) than they did during the 100-cpm session. The CPR quality deteriorated in numbers and percentile of effective compression since the third minute in the PF session and the fourth minute in the 100-cpm session. The percentile of compressions with adequate depth in the 100-cpm sessions was higher than that in the PF sessions during the second, third, and fourth minutes of CPR.
  
  
  CONCLUSIONS
  Push-fast technique showed a significant decrease in the percentile of effective chest compression compared with the 100-cpm technique during the 5-minute hand-only CPR. The PF technique exhibited a trend toward increased fatigue in the rescuers, which can result in early decay of CPR quality.
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Ming-Yuan
authors.initials: MY
authors.lastname: Hong
authors.affiliation: Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.
authors.forename: Jui-Yi
authors.initials: JY
authors.lastname: Tsou
authors.affiliation: Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Pai-Chin
authors.initials: PC
authors.lastname: Tsao
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chih-Jan
authors.initials: CJ
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Hsiang-Chin
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Tsung-Yu
authors.initials: TY
authors.lastname: Chan
authors.affiliation: Research Center of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Sheng-Hsiang
authors.initials: SH
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: chich@mail.ncku.edu.tw.
authors.forename: Chih-Hsien
authors.initials: CH
authors.lastname: Chi
authors.affiliation: Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Fong-Chin
authors.initials: FC
authors.lastname: Su
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000592:standards / Q000706:statistics & numerical data; D018592:Cross-Over Studies; D005260:Female; D006336:Heart Massage / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008348:Manikins; D005082:Physical Exertion; D013997:Time Factors; D055815:Young Adult