{"pk":10675,"title":"Team Size and Stretching-Exercise Effects on Simulated Chest Compression Performance and Exertion","subtitle":null,"abstract":"Introduction: Investigators conducted a prospective experimental study to evaluate the effectof team size and recovery exercises on individual providers’ compression quality and exertion.Investigators hypothesized that 1) larger teams would perform higher quality compressions withless exertion per provider when compared to smaller teams; and 2) brief stretching and breathingexercises during rest periods would sustain compressor performance and mitigate fatigue.\nMethods: In Phase I, a volunteer cohort of pre-clinical medical students performed four minutesof continuous compressions on a Resusci-Anne manikin to gauge the spectrum of compressorperformance in the subject population. Compression rate, depth, and chest recoil weremeasured. In Phase II, the highest-performing Phase I subjects were placed into 2-, 3-, and/or4-compressor teams; 2-compressor teams were assigned either to control group (no recoveryexercises) or intervention group (recovery exercises during rest). All Phase II teams participatedin 20-minute simulations with compressor rotation every two minutes. Investigators recordedcompression quality and real-time heart rate data, and calculated caloric expenditure fromcontact heart rate monitor measurements using validated physiologic formulas.\nResults: Phase I subjects delivered compressions that were 24.9% (IQR1-3: [0.5%-74.1%])correct with a median rate of 112.0 (IQR1-3: [103.5-124.9]) compressions per minute anddepth of 47.2 (IQR1-3: [35.7-55.2]) mm. In their first rotations , all Phase II subjects deliveredcompressions of similar quality and correctness (p=0.09). Bivariate analyses of 2-, 3-, and4-compressor teams’ subject compression characteristics by subsequent rotation did notidentify significant differences within or across teams. On multivariate analyses, only subjects in2-compressor teams exhibited significantly lower compression rat es (control subjects; p<0.01),diminished chest release (intervention subjects; p=0.03), and greater exertion over successiverotations (both control [p≤0.03] and intervention [p≤0.02] subj ects).\nConclusion: During simulated resuscitations, 2-compressor teams exhibited increased levels ofexertion relative to 3- and 4-compressor teams for comparable compression delivery. Stretchingand breathing exercises intended to assist with compressor recovery exhibited mixed effects oncompression performance and subject exertion.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"cardiopulmonary resuscitation"},{"word":"emergency treatment"},{"word":"human engineering"},{"word":"patient simulation"},{"word":"task performance and analysis"}],"section":"Critical Care","is_remote":true,"remote_url":"https://escholarship.org/uc/item/47h8z844","frozenauthors":[{"first_name":"Jessica","middle_name":"C.","last_name":"Schoen","name_suffix":"","institution":"Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island\nLifespan Medical Simulation Center, Providence, Rhode Island\nMayo Clinic Rochester, Department of Emergency Medicine, Rochester, Minnesota","department":"None"},{"first_name":"Jason","middle_name":"T.","last_name":"Machan","name_suffix":"","institution":"Rhode Island Hospital, Biostatistics Core, Providence, Rhode Island","department":"None"},{"first_name":"Max","middle_name":"","last_name":"Dannecker","name_suffix":"","institution":"Lifespan Medical Simulation Center, Providence, Rhode Island","department":"None"},{"first_name":"Leo","middle_name":"","last_name":"Kobayashi","name_suffix":"","institution":"Alpert Medical School of Brown University, Department of Emergency Medicine,\nProvidence, Rhode Island\nLifespan Medical Simulation Center, Providence, Rhode Island","department":"None"}],"date_submitted":"2017-03-16T21:36:38Z","date_accepted":"2017-03-16T21:36:38Z","date_published":"2017-09-11T07:00:00Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10675/galley/5838/download/"}]}