title: Rescuer factors predict high-quality CPR--a manikin-based study of health care providers.
abstract: BACKGROUND
  In the provision of high-quality cardiopulmonary resuscitation (CPR) by health care providers, factors associated with high-quality CPR should be explored.
  
  
  METHODS
  This is a post hoc analysis using data from a manikin-based survey of CPR quality among volunteer emergency medical technicians (EMTs) from 2 county fire departments in northern Taiwan.
  
  
  RESULTS
  Among the 95 enrolled EMTs, 36 (37.9%) performed high-quality CPR on a manikin. The baseline characteristics that differed significantly between groups were board-certified EMT levels (P = .010), body mass index (BMI, P = .029), average exercise frequency (P = .001), and average exercise duration (P = .005). Average total exercise time per week, which uses frequency times exercise duration, was independently associated with high-quality CPR performance after adjusting for variables via logistic regression analysis (odds ratio, 1.004; P = .044). An index was developed (BMI × ExeTime) based on the product of BMI and average total exercise time per week. A comparison of the area under curve for the different indices showed that BMI × ExeTime was a significant predictor of high-quality CPR, with an area under curve of 0.718 (95% confidence interval, 0.613-0.824; P < .001; Fig. 2) and a cutoff value of 4136.7 kg·min/m(2) (sensitivity, 0.722; specificity, 0.678).
  
  
  CONCLUSIONS
  This study identified factors associated with the performance by health care providers of high-quality CPR, including BMI and exercise habits. To optimize CPR quality, a program of exercise frequency and duration adjusted according to individual's BMI should be considered in such populations.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Linko, Taiwan.
authors.forename: Chi-Chun
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Linko, Taiwan; Department of Emergency Medicine, Xiamen Chang Gung Hospital, Xiamen, China.
authors.forename: Chan-Wei
authors.initials: CW
authors.lastname: Kuo
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Linko, Taiwan.
authors.forename: Chip-Jin
authors.initials: CJ
authors.lastname: Ng
authors.affiliation: Department of Occupation Medicine Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Emergency Medicine, Xiamen Chang Gung Hospital, Xiamen, China.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Li
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Linko, Taiwan; Department of Emergency Medicine, Xiamen Chang Gung Hospital, Xiamen, China. Electronic address: wengym33@gmail.com.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Weng
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Linko, Taiwan.
authors.forename: Jih-Chang
authors.initials: JC
authors.lastname: Chen
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D002568:Certification; D002983:Clinical Competence; D004634:Emergency Medical Technicians / Q000592:standards*; D015444:Exercise; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008348:Manikins; D010809:Physical Fitness; D013624:Taiwan