Abstract 245: Increasing Rescuer Height is Associated With Higher Frequency of Leaning During Chest Compressions
Background: Cardiac arrest survival is dependent in part on the quality of delivered CPR, including chest compression (CC) rate, depth and the frequency of CC leaning (incomplete release between CCs). Recent work has shown that CC leaning is common during actual resuscitation efforts and that leaning frequency appears to vary among rescuers. The rescuer characteristics that contribute to leaning remain unclear.
Objective: We hypothesized that rescuer height would be associated with increased leaning frequency during manikin resuscitation simulations with constant bed height.
Methods: We recruited hospital-based CPR-trained healthcare providers to perform CPR for two minutes on a manikin, placed in a hospital bed at a constant 61 cm (24 inch) bed height. Subjects were blinded to the purpose of the study. CPR characteristics were quantified using a CPR-recording monitor/defibrillator with audiovisual feedback disabled. Rescuer characteristics (age, gender, height, weight and CPR training history) were collected and statistically analyzed with regard to CPR performance characteristics.
Results: We studied 77 providers between 7/2009 and 4/2010. Cohort mean age was 33.3±9.3 years; 50% were nurses, and 22% were physicians or medical trainees. Mean height was 169.7±8.9 cm (66.8±3.3 inches). Mean CC rate was 104±20 per minute, mean CC depth was 50±15 mm, and mean leaning fraction was 0.27±0.4. Rescuers >170 cm in height (>67 inches) exhibited significantly more CC leaning than rescuers <170 cm (0.36±0.4 vs 0.17±0.3 leaning fraction, p=0.011). No statistically significant differences in CC rate or depth were noted between the two height groups, nor were significant differences in leaning fraction noted when analyzed by physician vs nurse or by year of CPR certification.
Conclusions: Increased rescuer height is associated with higher CC leaning frequency in our simulation cohort of trained providers. Our findings may explain the leaning variability in actual practice noted by a prior investigation. This may have important implications for CPR delivery in actual practice; taller rescuers should consider raising bed height during CPR or should be mindful of the increased possibility of leaning.
- © 2010 by American Heart Association, Inc.