Sustained manual abdominal compression during cardiopulmonary resuscitation in a pig model: a preliminary investigation

Park, C H; Jeung, Kyung Woon; Min, Yong‐Ki; Heo, Tag

doi:10.1136/emj.2008.070060

Cited by 10 publications

(7 citation statements)

References 18 publications

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“…Therefore, the maximum pressure point is usually the hypothenar side. However, if standing position and hand in contact with the sternum are both right, or both left, the hand position is shifted to the hypothenar side, which may compress closer to the xiphoid and increase the risk of blunt upper abdominal trauma 10 . Therefore, the hand position must not shift to the hypothenar side.…”

Section: Discussionmentioning

confidence: 99%

Adequacy of hand positioning by medical personnel during chest compression in a simulation study

Koyama

Matsuyama

Kainoh

et al. 2021

Acute Medicine & Surgery

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During chest compressions (CCs), the hand position at the lower half of the sternum is not strictly maintained, unlike depth or rate. This study was conducted to determine whether medical staff could adequately push at a marked location on the lower half of the sternum, identify where the inappropriate hand position was shifted to, and correct the inappropriate hand position.Methods: This simulation-based, prospective single-center study enrolled 44 medical personnel. Pressure and hand position during CC were ascertained using a flexible pressure sensor. The participants were divided into four groups by standing position and the hand in contact with the sternum: right-left (R-l), right-right (R-r), left-right (L-r), and left-left (L-l). We compared the groups and the methods: the manual method (MM), the thenar method, and the hypothenar method (HM).Results: Among participants using the MM, 80% did not push adequately at the marked location on the lower half of the sternum; 60%-90% of the inadequate positions were shifted to the hypothenar side. CCs with the HM facilitated stronger pressure, and the position was minimally shifted to the hypothenar side.Conclusion: Medical staff could not push at an appropriate position during CCs. Resuscitation courses should be designed to educate personnel on the appropriate position for application of maximal pressure while also evaluating the position during CCs.

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Section: Discussionmentioning

confidence: 99%

Adequacy of hand positioning by medical personnel during chest compression in a simulation study

Koyama

Matsuyama

Kainoh

et al. 2021

Acute Medicine & Surgery

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show abstract

“…Compression of the abdomen increases the risk of blunt upper abdominal trauma including injuries of the liver 26. Therefore, the safety issue should be resolved before chest compression at the sternoxiphoid junction is implemented in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Optimal position for external chest compression during cardiopulmonary resuscitation: an analysis based on chest CT in patients resuscitated from cardiac arrest

Cha

Kim²,

Shin

et al. 2012

Emerg Med J

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“…In this study, we found that the inadequate compression position occurred in the hypothenar side in the R-r and L-l subgroups, which poses a risk of pushing on the xiphoid that increases the risk of abdominal trauma, such as liver injury [20]. This result was similarly achieved by manual CCs [14] and the participants might have used the feedback device to deliver CCs resulting in the same sensation to manual CCs.…”

Section: Discussionmentioning

confidence: 69%

Adequacy of compression positioning using the feedback device during chest compressions by medical staff in a simulation study

et al. 2022

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Background The 2020 American Heart Association guidelines recommend the use of a feedback device during chest compressions (CCs). However, these devices are only placed visually by medical personnel on the lower half of the sternum and do not provide feedback on the adequacy of the pressure-delivery position. In this study, we investigated whether medical staff could deliver CCs at the adequate compression position using a feedback device and identified where the inadequate position was compressed. Methods This simulation-based, prospective single-centre study enrolled 44 medical personnel who were assigned to four different groups based on the standing position and the hand in contact with the feedback device as follows: right–left (R–l), right–right (R–r), left–right (L–r), and left–left (L–l), respectively. The sensor position where the maximal average pressure was applied during CCs using the feedback device were ascertained with a flexible capacitive pressure sensor. We determined if this position is the adequate compression position or not. The intergroup differences in the frequency of the adequate compression position, the maximal average pressure, compression rate, depth and recoil were determined. Results The frequencies of adequate compression positioning were 55, 50, 58, and 60% in the R–l, R–r, L–r, and L–l groups, respectively, with no significant intergroup difference (p = 0.917). Inadequate position occurred in the front, back, hypothenar and thenar sides. The maximal average pressure did not significantly differ among the groups (p = 0.0781). The average compression rate was 100–110 compressions/min in each group, the average depth was 5–6 cm, and the average recoil was 0.1 cm, with no significant intergroup differences (p = 0.0882, 0.9653, and 0.2757, respectively). Conclusions We found that only approximately half of the medical staff could deliver CCs using the feedback device at an adequate compression position and the inadequate position occurred in all sides. Resuscitation courses should be designed to educate trainees about the proper placement during CCs using a feedback device while also evaluating the correct compression position.

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Sustained manual abdominal compression during cardiopulmonary resuscitation in a pig model: a preliminary investigation

Abstract: SMAC using left paramedian compression technique failed to improve CPP during CPR and resuscitation outcomes. Furthermore, this method could not avoid liver laceration.

Cited by 10 publications

References 18 publications

Adequacy of hand positioning by medical personnel during chest compression in a simulation study

Adequacy of hand positioning by medical personnel during chest compression in a simulation study

Optimal position for external chest compression during cardiopulmonary resuscitation: an analysis based on chest CT in patients resuscitated from cardiac arrest

Adequacy of compression positioning using the feedback device during chest compressions by medical staff in a simulation study

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