Does Dual Operator CPR help minimize interruptions in chest compressions?

Abstract

Basic Life Support Guidelines 2005 emphasise the importance of reducing interruptions in chest compressions (no-flow duration) yet at the same time stopped recommending Dual Operator CPR. Dual Operator CPR (where one rescuer does ventilations and one chest compressions) could potentially minimize no-flow duration compared to Single Operator CPR. This study aims to determine if Dual Operator CPR reduces no-flow duration compared to Single Operator CPR. This was a prospective randomised controlled crossover trial. Medical students were randomised into 'Dual Operator' or 'Single Operator' CPR groups. Both groups performed 4 min of CPR according to their group allocation on a resuscitation manikin before crossing over to perform the other technique one week later. Fifty participants were recruited. Dual Operator CPR achieved slightly lower no-flow durations than the Single Operator CPR (28.5% (S.D.=3.7) versus 31.6% (S.D.=3.6), P<or=0.001). Dual Operator CPR was associated with slightly more rescue breaths per minute (4.9 (S.D.=0.5) versus 4.5 (S.D.=0.5), P=0.009. There was no difference in compression depth, compression rate, duty cycle, rescue breath flow rate or rescue breath volume. Dual Operator CPR with a compression to ventilation rate of 30:2 provides marginal improvement in no-flow duration but CPR quality is otherwise equivalent to Single Operator CPR. There seems little advantage to adding teaching on Dual Operator CPR to lay/trained first responder CPR programs.