Three-Rescuer CPR: The Method of Choice for Firefighter CPR?, , ,

Study objective: To compare the quality of CPR provided by firefighters performing three-rescuer CPR with that achieved by firefighters trained to provide standard two-rescuer CPR. Design: Eight months after training a large number of firefighters to perform three-rescuer CPR, we used a quasi-experimental design to compare the performance of a randomly selected subset of these companies to that achieved by a control group of engine companies that received refresher training in standard two-rescuer CPR. Both groups used bag-valve masks to provide rescue ventilations. Testing was conducted on a no-notice basis with a recording mannequin. Key actions were scored by an experienced observer using explicit pass-fail criteria. Mannequin-generated strip charts were used to calculate the rate and depth of chest compressions and the ventilatory rate, volume, and minute ventilation in a blinded manner. Setting: Fire stations of the Memphis Fire Department. The department is the sole provider of first-responder emergency care to the citizens of Memphis, Tennessee (population, 610,000). Results: Three-rescuer teams delivered a mean minute ventilation substantially greater than that produced by two-rescuer teams (7.7±5.3 L versus 4.9±4.2 L, P<.001). Intergroup differences in the mean depth of chest compressions were less marked, but they were still significant (17.2±8.3 mm of recorder-needle deflection versus 13.7±7.0 mm, P<.001). Conclusion: Three rescuers can produce better CPR than two when a bag-valve-mask device is used. The technique is easily learned and readily retained. [Hackman BB, Kellermann AL, Everitt P, Carpenter L: Three-rescuer CPR: The method of choice for firefighter CPR? Ann Emerg Med July 1995;26:25-30.]