Uninterrupted chest compression CPR is easier to perform and remember than standard CPR.

INTRODUCTION: It has long been observed that CPR skills rapidly decline regardless of the modality used for teaching or criteria used for testing. Uninterrupted chest compression CPR (UCC-CPR) is a proposed alternative to standard single rescuer CPR (STD-CPR) for laypersons in witnessed unexpected cardiac arrest in adults. It delivers substantially more compressions per minute and may be easier to remember and perform than standard CPR.

METHODS: In this prospective study, 28 medical students were taught STD-CPR and UCC-CPR and then were tested on each method at baseline (0), 6, and 18 months after training. The students' performance for at least 90 s of CPR was evaluated based on video and Laerdal Skillreporter Resusci Anne recordings.

RESULTS: The mean number of correct chest compressions delivered per minute trended down over time in STD-CPR (23 +/- 3, 19 +/- 4 , and 15 +/- 3; P = 0.09) but stayed the same in UCC-CPR (43 +/- 9, 38 +/- 7, and 37 +/- 7 = 0.91) at 0, 6, and 18 months, respectively. The mean percentage of chest compressions delivered correctly fell over time in STD-CPR (54 +/- 6%, 35 +/- 6%, and 32 +/- 6%; P = 0.02) but stayed the same in UCC-CPR (34 +/- 5%, 41 +/- 7%, and 38 +/- 8%) at 0, 6, and 18 months, respectively. The number of chest compressions delivered per minute was higher in UCC-CPR at 0, 6, and 18 months (113 versus 44, P < 0.0001; 94 versus 47, P < 0.0001; and 92 versus 44, P < 0.001). The greater number of chest compressions was due to a mean ventilaroty pause of 13-14 s during STD-CPR at all three time points.

CONCLUSIONS: Chest compression performance during STD-CPR declined in repeated testing over 18 months whereas there was minimal decline in chest compressions performance on repeated testing of UCC-CPR. In addition, substantially more chest compressions were delivered during UCC-CPR compared to STD-CPR at all time points primarily because of long pauses accompanying rescue breathing.