The Most Effective Rescuer's Position for Cardiopulmonary Resuscitation Provided to Patients on Beds: A Randomized, Controlled, Crossover Mannequin Study

Hong, Chong Kun; Park, Sang O; Jeong, Han Ho; Kim, Jung Hyun; Lee, Na Kyoung; Lee, Kyoung Yul; Lee, Younghwan; Lee, Jun Ho; Hwang, Seong Youn

doi:10.1016/j.jemermed.2013.08.085

Cited by 22 publications

(10 citation statements)

References 14 publications

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“…Variables that may influence compression depth include bed height, step stool utilization, 18 – 20 the rescuer’s height, 18 weight, 21 – 23 and gender, 23 , 24 and team focus on compression depth as an important aspect of resuscitation. One additional factor we observed was the position of the rescuer’s arms and shoulders relative to the point of compression over the chest.…”

Section: Introductionmentioning

confidence: 99%

A Simulation-based Randomized Controlled Study of Factors Influencing Chest Compression Depth

Mayrand¹,

Fischer²,

Eyck³

2015

WestJEM

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IntroductionCurrent resuscitation guidelines emphasize a systems approach with a strong emphasis on quality cardiopulmonary resuscitation (CPR). Despite the American Heart Association (AHA) emphasis on quality CPR for over 10 years, resuscitation teams do not consistently meet recommended CPR standards. The objective is to assess the impact on chest compression depth of factors including bed height, step stool utilization, position of the rescuer’s arms and shoulders relative to the point of chest compression, and rescuer characteristics including height, weight, and gender.MethodsFifty-six eligible subjects, including physician assistant students and first-year emergency medicine residents, were enrolled and randomized to intervention (bed lowered and step stool readily available) and control (bed raised and step stool accessible, but concealed) groups. We instructed all subjects to complete all interventions on a high-fidelity mannequin per AHA guidelines. Secondary end points included subject arm angle, height, weight group, and gender.ResultsUsing an intention to treat analysis, the mean compression depths for the intervention and control groups were not significantly different. Subjects positioning their arms at a 90-degree angle relative to the sagittal plane of the mannequin’s chest achieved a mean compression depth significantly greater than those compressing at an angle less than 90 degrees. There was a significant correlation between using a step stool and achieving the correct shoulder position. Subject height, weight group, and gender were all independently associated with compression depth.ConclusionRescuer arm position relative to the patient’s chest and step stool utilization during CPR are modifiable factors facilitating improved chest compression depth.

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Section: Introductionmentioning

confidence: 99%

A Simulation-based Randomized Controlled Study of Factors Influencing Chest Compression Depth

Mayrand¹,

Fischer²,

Eyck³

2015

WestJEM

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“…Earlier studies describe how CPR performed with the patient in a bed lowered to the rescuer's knee-level provides both correct compression depth as well as correct compression rate (15). The depth and rate of compression are also shown to be adequate when the rescuers kneel on the patient's bed or when rescuers are standing on a footstool next to the bed (15,16). This may indicate that changes are needed when CPR is performed in the military hospital setting.…”

Section: Compression Rate In Relation To Working Level At 2 Minutesmentioning

confidence: 99%

CPR performed in battlefield emergency care

Abelsson

Lundberg

2019

Australasian Journal of Paramedicine

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IntroductionDuring military missions medical care is provided to military personnel as well as civilians. Although cardiopulmonary resuscitation (CPR) may not be a common task in a military field hospital, all personnel need to be trained to deal with cardiac arrest.MethodsThis study was a comparative simulation study. Participants (n=36) from the Swedish armed forces performed CPR for 2 minutes at one of three different locations: at ground level, a military bed, or a transportable military stretcher. Compression depth and rate after 2 minutes of CPR and at the time of the participants’ own request to be relieved were measured. Descriptive and inferential analysis was conducted. ResultsThere is a direct correlation between compression depth and working level, concluding that the higher working level, the lower the compression depth. There is in total an overall low percentage of participants within limits for correctly conducted CPR regarding both compression depth and rate. Time to fatigue is related to working level, where increased level results in early fatigue. ConclusionThe quality of CPR is affected by the level at which it is performed. The quality of CPR was satisfactory when working at ground level, but suboptimal when working at hospital bed level or military stretcher level. When working at raised levels, participants appeared to misjudge their own compression depth and rate. This may indicate that changes are needed when CPR is practised in the military hospital setting. Future studies regarding the use footstools are required due to the height of military beds and transportable stretchers.

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“…That is why supporting methods based on visual feedback devices like the CPRmeter, among others, might be helpful. Moreover, incorrect upper limb position during chest compression may influence the rescuer workload [17,18]. This will, in turn, influence the rate of fatigue and negatively affect the quality of the CPR.…”

Section: Ijomeh 2017;30(6)mentioning

confidence: 99%

Influenece of the CPRmeter on angular position of elbows and generated forces during cardiopulmonary resuscitation

Kopacz

Fronczek–Wojciechowska

Jaźwińska

et al. 2017

Int J Occup Med Environ Health

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Objectives: It is commonly known that ergonomics in emergency medical services (EMS) is very important. Emergency medical services workers are exposed to different conditions and they should perform a variety of tasks. Material and Methods: The aim of the work has been to analyze the angular position of elbows and forces generated by the upper limbs during cardiopulmonary resuscitation with and without the CPRmeter based on feedback technology. Ten male paramedics and 10 male non-paramedics, in a kneeling position, performed cardiopulmonary resuscitation (CPR) on an Ambu Megacode manikin placed on the ground. Measurements were taken after 1 min and 4 min following the beginning of the trial. The angular position of the elbows was evaluated with a BTS Smart DX 7000 motion capture system. Kistler platforms 9286BA were used for measuring forces. Results: In the paramedic group, one statistically significant difference was observed in the mean difference between maximal and minimal right elbow angle in the 1st min without the device vs. the mean difference in the 4th min without the device. In the paramedic group, a 25% force decrease was observed after 4 min of resuscitation in trials without the CPRmeter in comparison to the 1st min. In trials with the CPRmeter, the force parameters were similar in the 1st and 4th min and more stable. No statistically significant differences were noticed in the control group. Conclusions: The CPRmeter has influence on the magnitude of the forces applied by the upper limbs and on the optimization of the rescuer effort during cardiopulmonary resuscitation. The CPRmeter had no influence on the position of the upper part of the kinematic chain. Int J Occup Med Environ Health 2017;30(6):909-916

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The Most Effective Rescuer's Position for Cardiopulmonary Resuscitation Provided to Patients on Beds: A Randomized, Controlled, Crossover Mannequin Study

Cited by 22 publications

References 14 publications

A Simulation-based Randomized Controlled Study of Factors Influencing Chest Compression Depth

A Simulation-based Randomized Controlled Study of Factors Influencing Chest Compression Depth

CPR performed in battlefield emergency care

Influenece of the CPRmeter on angular position of elbows and generated forces during cardiopulmonary resuscitation

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