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Relative, Perceived & Actual Work of CPR in the Lay Population

Flickinger, Katharyn (2022) Relative, Perceived & Actual Work of CPR in the Lay Population. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Cardiac arrest (CA) has a high incidence in the United States. With only a 10% average survival rate, out-of-hospital CA (OHCA) claims 366,000 lives annually. Cardiopulmonary Resuscitation (CPR) is a major predictor of outcome after OHCA. For CPR to be effective, rescuers must be able to perform high-quality chest compressions with regards to rate, depth, force, and release force. Performing CPR is physically demanding, with quality degrading as quickly as within the first 1-2 minutes after initiation. The American Heart Association (AHA) recommends rescuers alternate every 1-2 minutes, but rescuers may need to perform CPR for extended periods while waiting for further help, or for first responders to arrive.
Provider fatigue may be a major contributor to a decline in CPR quality. However, there is a lack of consensus over what provider-specific characteristics determine CPR quality and fatigue. Another factor affecting CPR quality is perceived fatigue, or how hard providers feel they are working. The effects of perceived fatigue combined with provider characteristics may affect CPR quality.
We conducted a prospective, randomized, counterbalanced experimental study to investigate CPR quality over time in both males and females, and when performed with and without quality feedback. We assessed CPR quality based on the following metrics: compression rate, depth, force, and release force. We hypothesized CPR quality would vary between men and women and on the basis of quality feedback We performed secondary analyses to evaluate how other covariates (time, age, height, weight, BMI, body fat, V ̇O2 max, V ̇O2 during compressions, muscular strength, muscular endurance, and RPE during compressions) affected CPR quality over a 10-minute period.
A total of 26 participants (age 25; IQR 22-37), 15 females (age 25; IQR 22-34), 11 males (age 24; IQR 21-60) completed the study. Three females could not perform 10 minutes of CPR. Rate declined over time, while perceived exertion increased, regardless of gender or feedback. Higher quality force and depth was associated with feedback, and higher muscular endurance. Lower release force (i.e., less leaning) was associated with females, leaner individuals, and higher muscular strength. These data suggest increased fitness levels may improve CPR quality metrics.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Flickinger, Katharynklh121@pitt.eduKLH121
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairGoss, Fredricgoss@pitt.eduGOSS
Committee MemberMenegazzi, Jamesmenegazz@pitt.eduMENEGAZZ
Committee MemberNagle, Elizabethnagle@pitt.eduNAGLE
Committee MemberCallaway, Clifcallaway@pitt.eduCALLAWAY
Committee MemberRittenberger, Jonjcrst19@pitt.eduJCR19
Date: 31 August 2022
Date Type: Publication
Defense Date: 17 June 2022
Approval Date: 31 August 2022
Submission Date: 27 July 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 137
Institution: University of Pittsburgh
Schools and Programs: School of Education > Health and Physical Activity
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: CPR, Cardiopulmonary Resuscitation, Provider Fitness, Emergency Medicine, Work of CPR, Fitness, Emergency Responder, First Responder, Lay-person CPR, Bystander CPR
Date Deposited: 31 Aug 2022 15:18
Last Modified: 31 Aug 2022 15:18


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