Dominant hand position improves the quality of external chest compression: a manikin study based on 2010 CPR guidelines

Cheng Jiang, Shan Jiang, Yan Zhao, Bing Xu, Xian-long Zhou
Journal of Emergency Medicine 2015, 48 (4): 436-44

BACKGROUND: The 2010 cardiopulmonary resuscitation (CPR) guidelines increased the importance of external chest compression. However, the best hand position to be the compressing one has not been identified.

OBJECTIVES: To investigate the effects of dominant or nondominant external chest compression hand position during CPR.

METHODS: Medical students performed five cycles of conventional CPR and completed one questionnaire. The CPR performances were manually evaluated, and detailed aspects of the external chest compression quality were assessed via the SimMan® Essential system (Laerdal China Ltd., Hangzhou, China).

RESULTS: One hundred fifty-seven students participated in the nondominant hand (NH) group, and 68 students participated in the dominant hand (DH) group. The manual evaluations revealed no differences between the two groups. The proportion of chest compressions "above 100 cpm [compressions per minute]" was higher in the DH group than in the NH group (97% vs. 92%, respectively, p = 0.002). The frequency distributions of the chest compression rates were also significantly different between the two groups (p < 0.0001). The distribution of the NH group was concentrated within "130-139" cpm, whereas this distribution was concentrated within "140-149" cpm in the DH group. The chest compression depth of the DH group was deeper than that of the NH group (p = 0.001). The depth of the fifth cycle was significantly decreased compared with those of cycles 1, 2, and 3 in the NH group. A greater number of full chest recoils were observed in the NH group (p = 0.02).

CONCLUSION: The dominant hand position during CPR was associated with a higher chest compression rate, a greater chest compression depth, and delayed fatigue.

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