Standard versus over-the-head cardiopulmonary resuscitation during simulated advanced life support.

BACKGROUND: Limited space can make rescuer position changes difficult during cardiopulmonary resuscitation (CPR). Over-the-head (OTH) CPR enables one rescuer to deliver chest compressions and ventilations without changing position. The aim of the present study was to evaluate quality of OTH versus standard CPR with bag-valve-mask (BVM) ventilation in a manikin model during advanced life support (ALS).

METHOD: In a randomised double-crossover trial, eight paramedic students performed ALS using both OTH and standard CPR with BVM. Initial rhythm was asystole, converting to ventricular fibrillation after atropine, adrenaline, and CPR. Data collection was stopped after atropine and epinephrine had been given. Data are presented as means +/- SD or median with 25% and 75% percentile.

RESULTS: There were no significant differences in ventilation or compression variables or any time factors with median total hands off times of 50% versus 52% for OTH and standard CPR respectively.

CONCLUSION: OTH CPR is an alternative method during CPR.