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Correlation between real-time heart rate and fatigue in chest compression providers during cardiopulmonary resuscitation: A simulation-based interventional study

 Go Eun Bae  ;  Arom Choi  ;  Jin Ho Beom  ;  Min Joung Kim  ;  Hyun Soo Chung  ;  In Kyung Min  ;  Sung Phil Chung  ;  Ji Hoon Kim 
 MEDICINE, Vol.100(16) : e25425, 2021-02 
Journal Title
Issue Date
Adult ; Cardiopulmonary Resuscitation / education ; Cardiopulmonary Resuscitation / methods* ; Emergency Medical Technicians / education ; Emergency Medical Technicians / statistics & numerical data* ; Fatigue / diagnosis ; Fatigue / physiopathology* ; Female ; Heart Rate / physiology* ; Humans ; Male ; Manikins ; Occupational Diseases / diagnosis ; Occupational Diseases / physiopathology* ; Prospective Studies ; Simulation Training ; Work / physiology ; Young Adult
Background: The American Heart Association guidelines recommend switching chest compression providers at least every 2 min depending on their fatigue during cardiopulmonary resuscitation (CPR). Although the provider's heart rate is widely used as an objective indicator for detecting fatigue, the accuracy of this measure is debatable. Objectives: This study was designed to determine whether real-time heart rate is a measure of fatigue in compression providers. Study design: A simulation-based prospective interventional study including 110 participants. Methods: Participants performed chest compressions in pairs for four cycles using advanced cardiovascular life support simulation. Each participant's heart rate was measured using wearable healthcare devices, and qualitative variables regarding individual compressions were obtained from computerized devices. The primary outcome was correct depth of chest compressions. The main exposure was the change in heart rate, defined as the difference between the participant's heart rate during individual compressions and that before the simulation was initiated. Results: With a constant compression duration for one cycle, the overall accuracy of compression depth significantly decreased with increasing heart rate. Female participants displayed significantly decreased accuracy of compression depth with increasing heart rate (odds ratio [OR]: 0.97; 95% confidence interval [CI]: 0.95-0.98; P < .001). Conversely, male participants displayed significantly improved accuracy with increasing heart rate (OR: 1.03; 95% CI: 1.02-1.04; P < .001). Conclusion: Increasing heart rate could reflect fatigue in providers performing chest compressions with a constant duration for one cycle. Thus, provider rotation should be considered according to objectively measured fatigue during CPR.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Kim, Ji Hoon(김지훈) ORCID logo https://orcid.org/0000-0002-0070-9568
Beom, Jin Ho(범진호) ORCID logo https://orcid.org/0000-0002-2805-257X
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Chung, Hyun Soo(정현수) ORCID logo https://orcid.org/0000-0001-6110-1495
Choi, Arom(최아롬)
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