Abstract 110: The Relationship Between Chest Compression Depth and Complete Chest Recoil Varies by Rescuer Type and CPR Technique
Introduction: Chest compression depth and complete chest recoil (CCR) are essential and hemodynamically significant components of CPR.
Hypothesis: We tested the hypothesis that there is a relationship between chest compression depth and frequency of CCR, dependent on rescuer type and CPR technique.
Methods: Randomized prospective trial performed on an electronic CPR manikin (Laerdal Skill Reporter™). Thirty laypersons (mean age 40.6 ± 8.4 years) trained in CPR, and thirty EMS providers (mean age 32 ± 8 years) who signed informed consent participated in the trial. Subjects performed three minutes of CPR using the standard hand position followed by three minutes of an alternative hands-off technique (lifting the heel and all fingers of the hand slightly but completely off the chest during the decompression phase of CPR). Chest compressions >38 mm were classified as adequate depth and incomplete chest recoil <1 mm classified as CCR. Groups were compared using a chi-squared analysis. Relative risk was defined as risk of CCR with inadequate compression depth.
Results: For layperson standard hand position, 24% (548/2264) of compressions with adequate depth had CCR and 21% (803/3838) of compressions with inadequate depth had CCR (RR 0.86 [0.79–0.95], p<0.0028). For EMS provider standard hand position, 12% (373/3015) of compressions with adequate depth had CCR and 18% (584/3166) of compressions with inadequate depth had CCR (RR 1.49 [1.32–1.68], p<0.0001). For layperson hands-off technique, 93% (1437/1551) of compressions with adequate depth had CCR and 92% (3779/4106) of compressions with inadequate depth had CCR. (p=NS) For EMS provider hands-off technique, 94% (2632/2791) of compressions with adequate depth had CCR and 95% (3276/3456) of compressions with inadequate depth had CCR. (p=NS).
Conclusions: Using the standard hand position, CCR was significantly more frequent with adequate compression depth for laypersons, (p<0.0028), and with inadequate compression depth for EMS providers (p<0.0001). Methods for monitoring CCR and providing rescuer feedback during standard hand position CPR are warranted. The hands-off technique resulted in a high incidence of CCR that was not significantly different with both adequate and inadequate compression depth.
- © 2010 by American Heart Association, Inc.