title: Low compliance with the 2 minutes of uninterrupted chest compressions recommended in the 2010 International Resuscitation Guidelines.
abstract: BACKGROUND
  We aimed to analyze compliance with 2010 European guidelines' quality criteria for external chest compressions (ECC) during 2 minutes of uninterrupted cardiopulmonary resuscitation.
  
  
  METHODS
  Seventy-two healthy nurses and physicians trained in advanced cardiopulmonary resuscitation performed 2 uninterrupted minutes of ECC on a training manikin (Resusci Anne Advanced SkillTrainer; Laerdal Medical AS, Stavanger, Norway) that enabled us to measure the depth and rate of ECC. When professionals agreed to participate in the study, we recorded their age, body mass index (BMI), smoking habit, and their own subjective estimation of their physical fitness. To measure fatigue, we analyzed participants' heart rates, percentage of maximum tolerated heart rate (MHR), and subjective perception of their fatigue on a visual analog scale.
  
  
  RESULTS
  Nearly half (48.6%) the rescuers failed to achieve a minimum average ECC depth of 50 mm. Only 48.1% of ECCs fulfilled the 2010 guidelines' quality criteria; quality deteriorated mainly after the first minute. Poor ECC quality and deteriorating quality after the first minute were associated with BMI < 23 kg/m(2). Rescuers with BMI ≥ 23 kg/m(2) fulfilled the quality criteria throughout the 2 minutes, whereas those with BMI < 23 kg/m(2) fulfilled them for 80% of ECCs during the first minute, but for only 30% at the end of the 2 minutes.
  
  
  CONCLUSIONS
  Compliance with the 2010 guidelines' quality criteria is often poor, mainly due to lack of proper depth. The greater depth recommended in the 2010 guidelines with respect to previous guidelines requires greater force, so BMI < 23 kg/m(2) could hinder compliance. Limiting each rescuer's uninterrupted time doing ECC to 1 minute could help ensure compliance.
authors: Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain; Cardiorespiratory Arrest Committee, Hospital Universitari Mútua Terrassa, Barcelona, Spain. Electronic address: balsango@yahoo.es.
authors: Baltasar
authors: B
authors: Sánchez
authors: Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain.
authors: Ramón
authors: R
authors: Algarte
authors: Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain.
authors: Enrique
authors: E
authors: Piacentini
authors: Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain.
authors: Josep
authors: J
authors: Trenado
authors: Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain.
authors: Eduardo
authors: E
authors: Romay
authors: Consell Català de Ressuscitació, Barcelona, Spain.
authors: Manel
authors: M
authors: Cerdà
authors: Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain.
authors: Ricard
authors: R
authors: Ferrer
authors: Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain; Cardiorespiratory Arrest Committee, Hospital Universitari Mútua Terrassa, Barcelona, Spain; Consell Català de Ressuscitació, Barcelona, Spain.
authors: Salvador
authors: S
authors: Quintana
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards*; D005221:Fatigue; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006336:Heart Massage / Q000379:methods / Q000592:standards*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008348:Manikins; D009726:Nurses; D010809:Physical Fitness; D010820:Physicians; D017410:Practice Guidelines as Topic; D011312:Pressure; D013997:Time Factors; D055815:Young Adult
keywords: Cardiopulmonary resuscitation prognosis; Cardiopulmonary resuscitation quality; Cardiopulmonary resuscitation simulation; Cardiopulmonary resuscitation training; Chest compressions; In-hospital cardiopulmonary resuscitation