Schittenhelm, Andrea; Brandt, Tom; Renker, Sean Paul; Schmidt, Annette
Dokumenttyp:
Zeitschriftenartikel / Journal Article
Titel:
Lower cardiopulmonary resuscitation quality after pre-resuscitation physical exertion and stress exposure in active firefighters
Untertitel:
a within-subject field study in a standardized operational setting
Zeitschrift:
Resuscitation Plus
Jahrgang:
29
Verlag:
Elsevier
Jahr:
2026
Umfang (Seiten):
7
Seitenbereich:
101344
Sprache:
Englisch
Abstract:
Introduction: Cardiopulmonary resuscitation (CPR) is a physically demanding intervention that is critical for survival following sudden cardiac arrest. While most studies focus on fatigue developing during resuscitation, emergency responders often initiate CPR after physically and psychologically demanding events. This study investigated changes in CPR performance following pre-exposure to physical and psychological stress in active firefighters. Methods: Twenty-three Caucasian firefighters (18 male, 5 female; body mass index = 25.4 ± 3.86 kg/m²; body fat = 19.7% ± 8.98%) participated in a within-subject field study. Each participant performed a standardized two-minute CPR session on a manikin before and after a fire service–typical operational task involving the use of a self-contained breathing apparatus. CPR performance was assessed using the SimPad Plus system by Laerdal Medical. Secondary outcomes included heart rate, salivary cortisol (nmol/L), salivary alpha-amylase (U/mL), and self-reported affect and anxiety. Results: Physiological markers indicated an acute stress response, with cortisol increasing by 236% (95% CI: 56–416%) and alpha-amylase by 60% (95% CI: 35–84%) (both p < 0.001). CPR quality declined significantly, with reductions in the overall performance score (−24%, 95% CI: 12–36%, p = 0.002, r = 0.81) and compression score (−36%, 95% CI: 18–55%, p = 0.001, r = 0.81). Discussion: These findings suggest that physical exertion prior to resuscitation may impair CPR quality, which is particularly relevant in physically demanding emergency settings. The results have potential implications for workload management and physical preparedness among emergency personnel. Keywords: cardiopulmonary resuscitation, emergency personnel, fire brigade, physical stress, physiology.