One-Minute Versus Two-Minute Compressor Rotation During Simulated Pediatric CPR (CPR-ROT)

One-Minute Versus Two-Minute Compressor Rotation During Simulated Pediatric CPR: A Randomized Crossover Pilot Study

The goal of this clinical trial is to compare one-minute and two-minute compressor rotation intervals during simulated pediatric cardiopulmonary resuscitation, also called CPR. The study will include healthcare professionals who perform chest compressions on a pediatric manikin in a simulated resuscitation setting.

The main questions this study aims to answer are:

Does one-minute compressor rotation improve chest compression quality compared with two-minute compressor rotation? Does one-minute compressor rotation reduce participant fatigue compared with two-minute compressor rotation?

Participants will perform chest compressions during two simulated pediatric CPR sessions. In one session, compressors will rotate every one minute. In the other session, compressors will rotate every two minutes. Researchers will compare CPR performance measures and participant-reported fatigue between the two rotation intervals.

Study Overview

• Status: Completed
• Conditions: Pediatrics; Resuscitation; Fatigue Symptom; Chest Compression Quality; Simulated Pediatric Cardiopulmonary Resuscitation
• Intervention / Treatment: Other: One-Minute Compressor Rotation; Other: Two-Minute Compressor Rotation

Detailed Description

This randomized crossover pilot study evaluates two different compressor rotation intervals during simulated pediatric cardiopulmonary resuscitation. The study is conducted in a simulation setting using a pediatric manikin. No patients are involved, and no clinical care is delivered.

Participants are healthcare professionals trained in pediatric resuscitation. Each participant pair completes two CPR scenarios. In one scenario, chest compressors rotate every one minute. In the other scenario, chest compressors rotate every two minutes. The order of the two scenarios is randomized.

The study compares objective CPR performance metrics obtained during the simulation, including measures related to chest compression quality. It also evaluates participant-reported fatigue after each scenario. Because each pair completes both rotation strategies, the crossover design allows comparison of the two approaches within the same participant pair.

The purpose of this pilot study is to explore whether a shorter compressor rotation interval may help maintain CPR quality or reduce fatigue during simulated pediatric CPR. The findings may help guide future simulation-based research and training strategies for pediatric resuscitation teams.

• Study Type: Interventional
• Enrollment (Actual): 18
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Ankara, Ankara, Turkey (Türkiye), 06230
      • Hacettepe University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Volunteer pediatric residents
• Previous cardiopulmonary resuscitation training
• Prior clinical cardiopulmonary resuscitation experience
• Ability to participate in both simulated pediatric CPR sessions
• Written informed consent provided before study participation

Exclusion Criteria:

• No previous Pediatric Advanced Life Support course attendance
• No prior clinical cardiopulmonary resuscitation experience
• Currently rotating in the pediatric emergency department or pediatric ward during the study period
• Emergency medicine residents
• Presence of a chronic medical condition that could affect physical performance during chest compressions

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: One-Minute Then Two-Minute Rotation Sequence; Participants in this arm first performed simulated pediatric CPR with compressor rotation every one minute. After a rest period, they performed a second simulated pediatric CPR session with compressor rotation every two minutes.	Other: One-Minute Compressor Rotation; During simulated pediatric cardiopulmonary resuscitation, chest compressors rotated every one minute. Participants performed chest compressions on a pediatric manikin, and CPR performance metrics were recorded during the simulation.; Other: Two-Minute Compressor Rotation; During simulated pediatric cardiopulmonary resuscitation, chest compressors rotated every two minutes. Participants performed chest compressions on a pediatric manikin, and CPR performance metrics were recorded during the simulation.
Experimental: Two-Minute Then One-Minute Rotation Sequence; Participants in this arm first performed simulated pediatric CPR with compressor rotation every two minutes. After a rest period, they performed a second simulated pediatric CPR session with compressor rotation every one minute.	Other: One-Minute Compressor Rotation; During simulated pediatric cardiopulmonary resuscitation, chest compressors rotated every one minute. Participants performed chest compressions on a pediatric manikin, and CPR performance metrics were recorded during the simulation.; Other: Two-Minute Compressor Rotation; During simulated pediatric cardiopulmonary resuscitation, chest compressors rotated every two minutes. Participants performed chest compressions on a pediatric manikin, and CPR performance metrics were recorded during the simulation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Chest Compression Rate During Simulated Pediatric CPR	Chest compression rate was recorded using a manikin-based CPR feedback device during each 20-minute simulated pediatric CPR session. The rate was compared between the one-minute and two-minute compressor rotation conditions.	From 0 to 20 minutes after the start of each simulated CPR session
Chest Recoil Velocity During Simulated Pediatric CPR	Chest recoil velocity was recorded using a manikin-based CPR feedback device during each 20-minute simulated pediatric CPR session and compared between the one-minute and two-minute compressor rotation conditions.	From 0 to 20 minutes after the start of each simulated CPR session
Proportion of Adequate Chest Compressions	The proportion of adequate chest compressions was defined as the proportion of compressions meeting the pre-specified rate and depth targets. Adequate compressions were defined as compressions delivered at a rate of 100 to 120 compressions per minute and a target depth of at least 5 cm	From 0 to 20 minutes after the start of each simulated CPR session

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Participant-Reported Fatigue	Participant fatigue was assessed using a 10-point Likert-type fatigue scale. Scores range from 1 to 10, with 1 indicating the least fatigue and 10 indicating the most fatigue. Higher scores indicate worse fatigue. Fatigue scores were compared between the one-minute and two-minute compressor rotation conditions.	At 4, 8, 12, 16, and 20 minutes after the start of each simulated CPR session
Blood Pressure Response Before and After Simulated Pediatric CPR	Systolic and diastolic blood pressure were measured at baseline and at the end of each 20-minute simulated CPR session. Blood pressure responses were compared between the one-minute and two-minute compressor rotation conditions.	At baseline and immediately after completion of each simulated CPR session
Heart Rate Response During Simulated Pediatric CPR	Participant heart rate was measured in beats per minute (bpm) using a standard monitor. Heart rate values were compared between the one-minute and two-minute compressor rotation conditions.	At baseline and at 4, 8, 12, 16, and 20 minutes after the start of each simulated CPR session

Collaborators and Investigators

• Sponsor: Hacettepe University

Publications and helpful links

General Publications

• Topjian AA, Raymond TT, Atkins D, Chan M, Duff JP, Joyner BL Jr, Lasa JJ, Lavonas EJ, Levy A, Mahgoub M, Meckler GD, Roberts KE, Sutton RM, Schexnayder SM; Pediatric Basic and Advanced Life Support Collaborators. Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020 Oct 20;142(16_suppl_2):S469-S523. doi: 10.1161/CIR.0000000000000901. Epub 2020 Oct 21. No abstract available.
• Sawee C, Churuangsuk C, Vattanavanit V. Effect of Compression Rotation Intervals on Cardiopulmonary Resuscitation Quality: A Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2025 Jun 25;13(1):e58. doi: 10.22037/aaemj.v13i1.2704. eCollection 2025.
• Kim DH, Seo YW, Jang TC. CPR quality with rotation of every 1 versus 2 minutes as characteristics of rescuers: A randomized crossover simulation study. Medicine (Baltimore). 2023 Mar 10;102(10):e33066. doi: 10.1097/MD.0000000000033066.
• Pechaksorn N, Vattanavanit V. CPR Compression Rotation Every One Minute Versus Two Minutes: A Randomized Cross-Over Manikin Study. Emerg Med Int. 2020 Sep 1;2020:5479209. doi: 10.1155/2020/5479209. eCollection 2020.

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2024
• Primary Completion (Actual): July 30, 2024
• Study Completion (Actual): September 1, 2024

Study Registration Dates

• First Submitted: May 21, 2026
• First Submitted That Met QC Criteria: May 29, 2026
• First Posted (Actual): June 3, 2026

Study Record Updates

• Last Update Posted (Actual): June 3, 2026
• Last Update Submitted That Met QC Criteria: May 29, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Fatigue; Simulation Training; Randomized Crossover Study; Pediatric Cardiopulmonary Resuscitation; Compressor Rotation
• Additional Relevant MeSH Terms: Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Fatigue
• Other Study ID Numbers: SBA24-1093 (Other Identifier: Hacettepe University Health Sciences Research Ethics Committee)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: The datasets generated and/or analyzed during the current study may be available from the corresponding author upon reasonable request, subject to approval by the study investigators and applicable institutional and ethical requirements.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No