Comparison of ventilation quality in novice and veteran lifeguards. a pilot simulation study

Abstract

Background: Lifeguards are fundamental in the resuscitation of the drowned person in cardiorespiratory arrest. In drowning victims, it is a priority to administer oxygenation. Different ventilation delivery techniques have been investigated and there is controversy about the most effective.

Goals: To compare the effect of mouth-to-mouth ventilation (VBB), bag-mask ventilation (VBM), and pocket-mask ventilation (VPM) on CPR quality between newly certified and active lifeguards

Method: 52 professional lifeguards (14 recently certified and 38 actives without training in basic life support (BLS) in the last year). Each lifeguard performed 3 randomized CPR tests on a Resusci Anne manikin connected to Wireless SkillReporter (Laerdal Medical, Stavanger, Norway) varying the ventilation technique: VBB, VBM, and VPM. CPR lasted 4 minutes, in pairs, with a change of roles after 2 minutes, and with the drowning protocol (starting with 5 rescue breaths). The global quality of CPR was calculated with the formula QCPR = (QCT + VVA)/2. Being QCT (quality of hand position + rhythm + thoracic reexpansion + depth) /4 and VVA the ventilations administered with an adequate volume (500-600ml).

Results: The recently certified inexperienced participants achieved better results in all the variables analyzed compared to the active professionals. This includes the overall quality of CPR with VBB (50.91±8.41% vs. 35.49±12.06%, p=0.002) and VPM (49.09±4.74% vs. 34.97±9.69%, p<0.001), as well as most of the ventilation quality variables with the 3 techniques: VBB, VBM and VPM.

Conclusions: Newly certified inexperienced rescuers perform better CPR, including ventilation, than those who have not received recent training. Frequent updating of the SVB abilities in lifeguards is key.

Keywords: Cardiopulmonary resuscitation, CPR, lifeguard, basic life, support.