Feasibility of a Modified Strategy for 2-Rescuer Cardiopulmonary Resuscitation

Christopher W. Root, Brian C. Deutsch, Sameer Lakha, Anjan Shah, Hung Mo Lin, Jaime B. Hyman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Cardiopulmonary resuscitation (CPR) requires effective chest compressions and ventilations to circulate and oxygenate blood. It has been established that a 2-handed mask seal is superior when providing bag-valve-mask (BVM) ventilations. However a 1-handed technique remains the standard with which health care providers are trained to perform 2-rescuer CPR. Objectives: We sought to determine if a modified 2-rescuer CPR technique that incorporates a 2-handed mask seal during ventilations can be accomplished without compromising chest compression quality during a simulated cardiac arrest. Methods: Medical student volunteers were divided into an “intervention” arm, with 1 rescuer creating a 2-handed mask seal and the second rescuer performing chest compressions followed by that second rescuer squeezing the BVM bag to deliver ventilations during compression pauses, and a “control” arm, in which standard 2-rescuer CPR was performed. Both arms received a brief CPR refresher following a standard script. The 2 rescuer teams then performed 2 rounds of CPR on a manikin while being video recorded. Data were collected from real-time evaluation and post hoc video analysis. Results: Forty-seven pairs of students enrolled in the study. There were no statistically significant differences between the intervention and control arms for median (interquartile range [IQR]) compression fraction (72% [69.5–75.7%] vs. 73.2% [69.1–76.1%]; p = 1.0), median time to complete 2 rounds of CPR (207.8 s [198.5–222.9 s] vs. 214.7 s [201.3–219.5 s]; p = 0.625), median hands-off time (49.8 s [46.2–63.0 s] vs. 55.4 s [50.4–65.2 s]; p = 0.278), or median time for 30 compressions (15.2 s [14.3–15.9 s] vs. 15.4 s [14.6–16.3 s]; p = 0.452). Conclusion: Two-rescuer CPR incorporating a 2-handed face mask seal can be performed effectively without impacting chest compression quality during simulated cardiac arrest.

Original languageEnglish
Pages (from-to)51-58
Number of pages8
JournalJournal of Emergency Medicine
Issue number1
StatePublished - Jul 2019


  • CPR
  • airway management
  • simulation


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