What question did this study set out to answer?

To compare the effect of different surfaces on the fatigability of clinicians performing CPR.

May 30, 2026

Effect of Compression Surfaces on Cardiopulmonary Resuscitation Quality and Clinician Fatigue

Key Points

To compare the effect of different surfaces on the fatigability of clinicians performing CPR.
Pilot randomized trial conducted with EMS clinicians in North Carolina
Participants performed CPR on a manikin on either a floor or standard mattress
Primary outcome measured was time to failure of compressions.
Time to failure was 145 seconds on floor vs. 140 seconds on mattress (p = 0.64)
Median compression rate was 112 on floor vs. 105 on mattress (p = 0.12)
No statistically significant difference in time to failure was found between surfaces (p = 0.4).

Abstract

OBJECTIVES: Current American Heart Association (AHA) guidelines recommend moving patients to a hard surface, when possible, to improve cardiopulmonary resuscitation (CPR) quality. However, the time to move a patient detracts from the time actively performing CPR. Studies show mixed results on the effect of a soft surface on CPR quality. The primary objective of this study was to compare the fatiguability of performing CPR on the floor versus a standard mattress. METHODS: This pilot randomized trial enrolled currently employed emergency medical services (EMS) clinicians from two EMS agencies in North Carolina from 10/2022 to 12/2022. Participants performed continuous compressions on a CPR manikin with integrated electronic feedback, randomized 1:1 to a floor or a mattress. The primary outcome was time to failure, defined as voluntary cessation of compressions by the participant or 30 seconds of inadequate compressions. Adequate compressions were defined using the current AHA recommendations for high-quality CPR, including a compression rate of 100-120/min and depth of at least 2 in. We describe time to failure and compression rate with median and interquartile range (IQR), and compare them between surfaces with the Wilcoxon Rank-Sum test. We constructed a survival curve of the time to failure by surface and compared them with a log-rank test. RESULTS: Among 40 participants, 47.5% (19/40) were female and 90.0% (36/40) were White with an average age of 28 (IQR 24-33) years. The time to failure for floor CPR was 145 seconds (IQR 65-240) vs. 140 seconds (IQR 100-420) for mattress CPR (p = 0.64). Floor participants performed compressions at a median rate of 112 (IQR 104-118) compressions per minute vs. 105 (IQR 101-113) compressions per minute for mattress participants (p = 0.12). Using a survival analysis, the time to failure was not statistically different between surfaces (p = 0.4). CONCLUSIONS: This prospective pilot study suggests no difference in fatigability of a person performing CPR on a mattress versus a floor. Further study is necessary to validate our findings.

Ask AI

Helpful

Bookmark