Comparison of the Effects of Three Different Counting Methods on Cardiopulmonary Resuscitation Quality and Rescuer Fatigue

Background: Chest compression with adequate depth and number is one of the main indicators of high-quality cardiopulmonary resuscitation (CPR). Nevertheless, no proper counting technique is suggested to provide sufficient number of massages. Aim: To compare the effects of three techniques of chest compression counting on the quality of CPR and rescuer fatigue. Method: In this clinical trial, 30 rescuers (divided into three groups) performed all the three techniques of chest compression counting (without counting [common], alternate [counting from 1 to 10], and continuous [counting from 1 to 100]) in 90 different resuscitation events at Ghaem Hospital of Mashhad, Iran, in 2015. Rescuer fatigue was evaluated using visual analogue scale to evaluate fatigue, and quality of massage was evaluated by the level of end-tidal CO2 (ETCO2); massage was calculated in minutes. Data was analyzed in SPSS using ANOVA and Friedman test. Results: The mean age of the rescuers was 30.6±6.8 years. Based on Kruskal-Wallis test results, common, continuous, and alternate techniques were in descending order of fatigue level, and the common, alternate, and continuous techniques were in descending order of number of massages. In addition, according to ANOVA, the highest ETCO2 levels were observed in the alternate, continuous, and common techniques, respectively; the difference between the techniques was significant (P 0.001). Implications for practice: The use of alternate counting technique reduces rescuer fatigue, elevates ETCO2 during resuscitation, and makes approximating the number of massages to the number advised by the American Heart Association possible.