Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Getting in Shape to Perform CPR

Cardiopulmonary resuscitation (CPR) is not trivial a exercise. It takes conditioning and coordination to be able to sustain the physical activity of compressing on someone’s chest 30 to 50 times per minute, and even more so if the victim is large, barrel-chested, and somewhat stiff. I have been in situations (hypothermic victims) where I was required to perform CPR for more than 30 minutes, and it wasn’t easy. I found myself struggling to maintain the proper rate and force to maintain the recommended amount of chest wall compression to generate sufficient cardiac output.  It was a question of conditioning, of being in shape to perform a prolonged exercise. Being fit definitely helped.

In a recent issue of the European Medical Journal (2011, 18:251-256), Sun-Myongs Ock and colleagues addressed the issue of “Influence of physical fitness on the performance of 5-minute continuous chest compression.”  The purpose of their study was to evaluate the influence of the CPR provider’s physical fitness on the quality of chest compression and physiological changes during continuous chest compressions for 5 minutes. Note that 5 minutes is not a very long time when it comes to CPR. They also investigated the possible effects of the rescuer’s sex, weight, and height on the quality of CPR performed. To do this study, mannequins were used. Before performing CPR, the “rescuers” were assessed using common measures of physical fitness, including maximal aerobic exercise capacity, muscle strength, muscle power, muscle endurance, and reactive agility. To evaluate the physical strain, multiple parameters were monitored, including ratings of perceived exertion, heart rate, breathing, production of carbon dioxide per minute, and volume of oxygen consumption.

The results were not surprising, but they are a wake-up call for anyone who believes that he or she is sufficiently fit to perform CPR for even 5 minutes. There was a significant reduction in the percentage of correct compressions after the first minute, such that by the fifth minute, only 28% of compressions were correct. Looking at all the parameters measured, only muscle strength affected the quality of correct chest compression. As noted by the authors, the results of the study suggest that a fitness program, such as muscle strength exercise for CPR providers, should be considered for improving survival from cardiac arrest

I don’t know about survival, but getting stronger would seem to help with the quality of compressions performed during CPR. I know that it takes a certain amount of muscular strength to perform certain orthopedic procedures, such as the reduction of a dislocated shoulder, elbow or hip, and the abillity to properly perform the chest compressions of CPR is no different. It should also be noted that it’s not just being able to strike the hammer firmly enough on the stump to ring the bell, but being able to strike it over and over again and keep ringing the bell for as long as it takes.

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Tags: Staying Safe

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.