Study of a Modified Two-person Cardiopulmonary Resuscitation Method to Provide Effective Ventilation: Analysis Based on a Rescuer's Training Proficiency

ABSTRACT

PURPOSE: The purpose of this study is to compare the modified two-person cardiopulmonary resuscitation method (MM) (the first resuscitator performs chest compressions and squeezes the bag of bag-valve-mask (BVM) during pauses of compression, and the second resuscitator uses two hands to provide an open airway) using the conventional two-person cardiopulmonary resuscitation method (CM). METHODS: This simulation study used a manikin and a cross-over execution design and included 102 participants. After practice of CM and MM, participants were randomly assigned a partner. Each pair of participants performed the 2-CPR for five cycles using both methods alternately at random. All data were recorded in a personal computer and analyzed. RESULTS: Data from 510 cycles each of the CM and MM were analyzed. The MM generated a higher mean tidal volume (TV) (791.2 ml versus 563.8 ml, P<0.001) and more frequent visible chest ventilation (92.1% versus 64.7%, P<0.001). For the inexpert resuscitator group (50; 49%), the MM generated more frequent visible chest ventilation (88.6% versus 34.0%, P<0.001) and ventilation with an adequate TV (43.6% versus 32.0%, P<0.001). No significant difference in compression rate, depth, hand position, and release, and minimal difference of hands off time (0.5s) were observed between the two methods. CONCLUSION: The CM could not easily provide sufficient visible chest rise and might be a poor ventilation option for inexpert BVM resuscitators. The MM can be useful as an alternative method and preferable to the CM for inexpert BVM resuscitators.