Role of Dominant Hand Position during Chest Compression by Novice Rescuers: An Observational Simulation Study

Abstract

Introduction The aim of this study was to determine the effect of hand positioning on the quality of external chest compression (ECC) by novice rescuers. Methods This observational simulation study was conducted for 117 included participants. After completion of an adult cardiopulmonary resuscitation (CPR) training program for 3-h, the participants selected which of their hands would be in contact with the mannequin during ECC and performed 5 cycles of single rescuer CPR on a recording mannequin. The participants were assigned to 2 groups: the dominant hand group (DH; n=40) and the non-dominant hand group (NH; n=29). The depth and rate of ECC were analysed to compare the effectiveness of ECC between 2 groups. Results The rate of ECC was significantly faster in the DH group (mean, 117.3 ±11.4/min) than in the NH group (mean, 110.9±12.2/min) (p=0.028). However, the depth of ECC in the dominant hand group (mean, 52.4±5.9 mm) was not significantly different from that in the non-dominant hand group (mean, 50.8±6.0 mm) (p=0.287). Similarly, the portion of ECC with inadequate depth in the dominant hand group (mean, 1.8±4.3%) was not significantly different from that in the non-dominant hand group (mean, 5.3±15.6%) (p=0.252). Conclusions ECC can be performed with an acceptably higher rate of compressions when the dominant hand of the novice rescuer is placed in contact with the sternum. However, the position of the dominant hand does not affect the depth of ECC. (Hong Kong j.emerg.med. 2014;21:382-386)

Impact of Hand Dominance on Effectiveness of Chest Compressions in a Simulated Setting: A Randomised, Crossover Trial

“…The present study investigated individual components of the overall ECC performance, those being ECC depth, ECC rate and ECC release (recoil). With regard to handedness and ECC depth, the present study's result of no difference is consistent with the majority of existing data (4)(5)(6)9), but in contrast to Wang et al and Kundra et al who found more optimal depth being achieved when the dominant hand was on the chest (7,8).…”

“…With regard to handedness and ECC rate, the present study finding of no difference challenges results from three earlier simulation studies that both reported significant differences favouring dominant hand on the chest evidenced by higher mean compression rates (4)(5)(6). While DHOC resulted in significantly higher mean rates, the rates of both groups in each study were comfortably within the recommended guideline parameters for effective ECC raising the question of whether the reported differences would be clinically significant.…”

“…Using an objective manual assessment process, no difference was found between the dominant and nondominant hand position. The remaining studies contributing to the existing body of evidence focussed on individual components of ECC, mainly compression rate, depth and release (recoil) (4,(6)(7)(8)(9). Comparability of results across this small body of evidence is difficult due marked heterogeneity in setting, design, participant groups and, in particular, the type of ECC being used as the intervention.…”

A comparison of the effect of two methods of positioning the hands during basic and advanced cardiovascular life support on the chest compression depth in adults

“…In other words, right-handedness or left-handedness did not affect the depth of chest compression during resuscitation. However, Jo et al 12 suggest that ECC in the group that used dominant hand was significantly faster than the group that used non-dominant hand. The contact of the dominant hand with the chest can affect the depth of chest compression.…”