Training on a stiff manikin with pressure detection or on a pulseless human with an arterial line in place? Prior to that experience, I had extensive training/ACLS on manikins like everyone else. It's definitely NOT the same; its also going to vary with the size of the person, amount of SQ fat etc. as well as surface the person is laying on. My training was long, long ago; before manikins offered advanced pressure feedback and their price point was lowered, but it's definitely still not the same. The LUCAS machines mentioned compress the sternum two inches. My point in bringing this up was just in the discussion of Damar Hamlin lifting his arms above his head so soon and with that vigor. Yes, CPR can be successful in the absence of rib fractures, especially depending on the age of the person (the younger, less likely to have fractures), but rib fractures from CPR should never be considered malpractice. Tiring? Absolutely, especially if you are wearing a lead apron too! Adrenaline helps us weaker folks in the moment, but you sure feel it later if you are deconditioned!
My other concern on this topic I didn't bring up before but others here alluded to is the effectiveness of CPR in the recent SADs scenarios we are encountering from that "thing" (you know, climate change and all). My understanding is even with ROSC, the amount of survival two weeks out from the recent Sudden Deaths is much less than previous Sudden Death scenarios. I would be interested to see the data on this topic.
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