The Effect of Fatigue Caused by Search and Rescue Efforts in the Debris on the Quality of Cardiopulmonary Resuscitation: A Randomized Controlled Trial

Introduction Cardiopulmonary Arrest (CPA) is among the leading cause of death worldwide. Each year, 375,000 people are reported to die in Europe and 250,000 in the United States due to CPA. Early diagnosis of arrest and Cardiopulmonary Resuscitation is life-saving. However, earthquakes, one of the deadliest disasters, are among the most challenging situations that people around the world have to face. The rate of rescue of survivors from earthquake or collapsed structures is reported to decrease by 50% following 24 hours. Therefore, the first 72 hours are crucial for search and rescue operations in disasters. In earthquakes, while some of the disaster victims experience arrest at the scene due to trauma, others experience arrest in early or late periods depending on the injury site and localization. Thus, search and rescue operations should be initiated quickly, effectively and swiftly in disaster areas. Properly and efficiently administered CPR is among the most crucial life-saving emergency medical care methods. In Turkey, paramedics are also deployed to National Medical Rescue Team (NMRT) units to support search and rescue activities and provide emergency medical care. Paramedics have difficulties in maintaining chest compressions in arrest cases, especially in challenging cases in tight spaces outside the hospital. Since chest compressions are considered the essential element of CPR, their quality is thought to be affected under harsh conditions. 2015 International Liaison Committee on Resuscitation (ILCOR) recommended the compression depth as 5-6 cm and stated that 1/3 of the sternum should be compressed owing to the body mass differences of the rescuers. However, effective CPR depends on many parameters such as the number of rescuers, elapsed time, physical characteristics and muscle strength of the rescuer, high level of fitness, fatigue, weight of the rescuer, physical fitness, having a higher maximum oxygen consumption, position of the rescuer, difficult and confined space rescues. This study aimed in this context, to measure the effects of fatigue on CPR using high-quality simulators.