Introduction
Whitewater activities such as rafting, canoeing, and kayaking are growing in popularity throughout the country. More than 17 million Americans participated in these activities in 2008 alone. With this increase in participation has come an increase in paddling-related fatalities. It is estimated that 25% to 30% of all deaths are attributable to cardiac arrest.
Objective
To examine the effects of a personal flotation device (PFD) on cardiopulmonary resuscitation (CPR) chest compression depth.
Methods
This is a prospective study, using volunteers certified in CPR by the American Heart Association (AHA) and the Laerdal Medical Simulation Mannequin (SimMan) to evaluate the efficacy of chest compressions while wearing 3 different PFD styles. Compression depth, rate, and variance were recorded during 2-minute cycles of chest compressions and averaged for each test group. Statistical analysis was performed using a student’s t-test.
Results
Data were compared between the control group and 3 different PFD styles measuring compression depth and rate (n = 37 per group). All groups had adequate rates of compression. The mannequin without a PFD (control) demonstrated an average depth of 49.5 mm. The 3 PFD styles allowed an average compression depth of 48.7 mm (P = .61), 45.7 mm (P < .016), and 45.2 mm (P < .019).
Conclusion
2015 AHA guidelines recommend adult CPR compression depth of 50 to 60 mm. Other studies have shown maximum survival at lower compression depth ranges (peak 45.6 mm). Optimal CPR efforts may be achievable in suspected drowning victims while wearing a PFD, but did not reach current AHA compression depth guidelines. While there was a statistically significant difference in compression depth achievable among the 3 varieties of PFDs, its clinical significance (3–4 mm in depth) is uncertain. Further studies are needed to test other PFDs, in particular those that are used in the commercial rafting industry.