Low compliance with the 2 minutes of uninterrupted chest compressions recommended in the 2010 International Resuscitation Guidelines.
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.
['Sánchez|Baltasar|B|', 'Algarte|Ramón|R|', 'Piacentini|Enrique|E|', 'Trenado|Josep|J|', 'Romay|Eduardo|E|', 'Cerdà|Manel|M|', 'Ferrer|Ricard|R|', 'Quintana|Salvador|S|']
D000328:Adult D015992:Body Mass Index D016887:Cardiopulmonary Resuscitation D005221:Fatigue D005260:Female D019983:Guideline Adherence D006336:Heart Massage D006339:Heart Rate 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
Chest compressions Cardiopulmonary resuscitation prognosis Cardiopulmonary resuscitation quality Cardiopulmonary resuscitation simulation Cardiopulmonary resuscitation training In-hospital cardiopulmonary resuscitation