There’s no reason to believe the guys I work with are more fit or strong than the average Korean medical student. That’s why a study out of European Journal of Emergency Medicine is somewhat unsettling. The study looks at strength and fitness levels and how they translate into CPR performance. 

The study can be found here.

47 medical students, well trained in CPR, underwent some general strength and fitness tests. Then they did chest compressions for five minutes straight on a high tech training mannequin that fed back the rate and quality of the compressions. Simultaneously some fitness related parameters were recorded.

They found a correlation between muscle strength and quality of the compressions. For all other factors, such as sex, height, weight, ‘agility’, muscle endurance and so on, there was no correlation after adjusting for muscle strength.

That fitness or strength translates into better CPR is a no-brainer. There something else that gets me with this study. Let’s instead assume that the students fitness and strength levels are representative of the average rescuer.

Then look at the diagram below.

First of all, the participants was able to maintain the compression rate throughout the five minutes. Maybe not so strange given how much emphasis is given on maintaining the rate in CPR training.

Unfortunately, they seem to be maintaining that rate on behalf of quality. Which obviously has to do with strength and fitness that doesn’t match the physical requirements of proper CPR.

Looking at the columns for all participants it seems only about 80% of the compressions are of adequate quality during the first minute of CPR.. That’s not good. And it gets worse. Going down the columns we see how after one minute only about 60% of the compressions are adequate. Dropping all the way down to 25% after four minutes.

The study reminds us that CPR is hard work and that we must have a plan for who does the compressions and that they should swap often. The guidelines recommend every second minute but that might not be enough. Are average fitness levels enough for efficient CPR?

Links are here.

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