Metabolic and Performance Differences of Cardiopulmonary Resuscitation Between a Hard Surface and Hospital Mattress

Cardiopulmonary Resuscitation is the most important procedure to preserve life following cardiac arrest. However, less than 15% of people survive. A major contributor may be improper compressions during CPR related to the surface on which the patient is lying. METHODS. Thirty-four participants participated in a randomized cross-over design using 2 -conditions (AHA BLS CPR on a hard surface and AHA BLS CPR on a hospital mattress) for a total of 24 minutes. Participants were wore a VO2MasterPro analyzer mask while performing CPR on a QCPR Little Anne CPR mannequin. Participants were assessed for Heart Rate, VO2, Ve/VO2, and FeO2. Compression Depth (mm), Rate (cpm), and RPE. RESULTS. On a mattress instead of hard surface: *Heart rate average was 4bpm higher *Oxygen consumption was 15L higher *Expirations/Oxygen used was 3L higher *Expiatory oxygen was 0.7L less *CPR depth was 3.4 mm less *RPE was 0.5 points higher at the midpoint and 0.2 overall *DISCUSSION. We found that the energy expenditure and quality of compressions were all compromised when providers performed CPR on a hospital mattress instead of on a hard surface. Wallace et al. (2013) and Talikowska et al. (2015) found that the mean difference in compression depth between survivors and non-survivors was only 2 to 3 mm. CPR on a mattress decreases depth by 3.4mm. Additionally, it requires more energy and is more difficult to perform compressions. The added energy and effort of CPR on a mattress leads to reduced quality and endangers patients' lives.