Compression to ventilation ratio series#

CPR electrodes were applied onto sternum and connected to a Zoll R Series Monitor/Defibrillator (ZOLL Medical Corporation, Chelmsford, MA, USA) to record CPR-quality parameters. Two CPR training manikins were used: Resuscijunior and Resuscibaby (Laerdal, Wappingers Falls, NY, USA). All participants provided their informed consent. Twenty-six volunteer senior medical students who recently completed a basic pediatric CPR course. The study was approved by the Gregorio Marañón Ethics Committee of Madrid, Spain. The CPR was performed by medical students and pediatric residents and two manikins were used: infant and child model. We designed a prospective randomized parallel controlled study of simulated pediatric CPR to compare the depth and rate of CC using a 15:2 vs 30:2 compression-to-ventilation ratio in manikins. The secondary aim was to describe the visual assessment of the quality of resuscitation in both scenarios. For this purpose, the main objective was to compare the quality of chest compressions and performance of single rescuer CPR comparing two compressions-to-ventilation ratios 15:2 and 30:2 in a simulated scenario with two manikins (infant and child model). The hypothesis of the study is that the quality of chest compressions is the same with 15:2 as 30:2 ventilation-to-compression ratio in a pediatric simulation model. In our knowledge, there are no previous studies comparing the quality of CC between 15:2 and 30:2 compression-to-ventilation ratio during pediatric CPR conducted by volunteers training in basic life support. However, only one study conducted in pediatric models, but it was developed by volunteers with pediatric advanced life support (PALS) accreditation 15. In adult simulation models 12, 13, 14, there are different studies that compare the quality of CC in both compression-to-ventilation ratio. In the other hand, different recommendations for the compression-to-ventilation ratio between children (15:2 ratio) and adults (30:2 ratio) could increase the errors or omissions and impair learning. The 15:2 ratio delivers more ventilations whereas the 30:2 ratio delivers more chest compressions (CC). Firstly, maintaining an adequate ventilation is crucial during CPR in children because pediatric CA is primarily caused by respiratory failure 2. However, there is not a strong evidence to indicate the best compression-to-ventilation ratio in pediatric CPR 10, 11. The 2015 European Resuscitation Council (ERC) guidelines recommend a synchronized 15:2 compression-to-ventilation ratio during basic pediatric CPR 1, 8, 9.

Nevertheless, many studies documented that CPR is often not optimally performed 6, 7. Previous studies have shown that optimizing maneuvers of cardiopulmonary resuscitation (CPR) in children could improve survival and prognosis 4, 5. Pediatric cardiac arrest (CA) is an important health problem since it has high mortality (52–80%) and a large proportion of survivors suffer from permanent and severe neurologic disability (poor outcome in 20–50%) 1, 2, 3, 4. Errors or omissions were frequently made by rescuers during resuscitation. The conclusions were that a high percentage of CC were not performed with optimal depth and rate. In the assessment of compliance with the ERC CPR algorithm, 69.2–80.8% of the subjects made some errors or omissions during resuscitation, the most frequent was not asking for help and not giving rescue breaths. No differences were found in depth or rate of CC between 15:2 and 30:2 compression-to-ventilation ratio with both manikins. Between 54–62% and 44–53% of CC were performed with an optimal rate and depth, respectively, with no significant differences. Visual assessment of resuscitation was performed by an external researcher. A total of 26 volunteers performed 104 CPR sessions.

Depth and rate of chest compressions (CC) during resuscitation were measured using a Zoll Z series defibrillator. Each subject did 4 CPR sessions of 3 minutes each one. The CPR was performed by volunteers who completed an basic CPR course. A prospective randomized parallel controlled study comparing 15:2 and 30:2 ratio in two manikins (child and infant) was developed. The secondary aim was to analyze the errors or omissions made during resuscitation.

The main objetive was to compare 30:2 and 15:2 compression-to-ventilation ratio in two simulated pediatric cardiopulmonary resuscitation (CPR) models with single rescuer.

Compression to ventilation ratio