Abstract 269: Look Ma, No Hands! Cardiopulmonary Resuscitation

Abstract

Background: CPR saves lives. Community-based, bystander CPR increases survivability by reducing time to compressions. Inadequate chest compressions have been associated with poor patient outcome. There is substantial inter-operator variability in quality and duration. While training laypersons in CPR, we observed that individuals lacking upper body strength had difficulty sustaining effective compressions. An improvised compression technique, transferring the force to the operator’s forearm, immediately resolved this issue. Objective/hypothesis: We hypothesized that a modified technique would be associated with increased duration of adequate compressions relative to standard CPR. Methods: Using a convenience sample of 18 paramedic students, we standardized this forearm technique and compared duration of adequate compressions with Standard CPR using Laerdal PC SkillReporting software. Trials were terminated upon 5 consecutive inadequate compressions. Evaluators were blinded to which sequence-randomized technique was being used. Our case-crossover study was approved by the university IRB. Results: Limitations: The small, convenience sample of young, fit providers trained in CPR was not representative of the group for whom the improvisation was originally devised. Larger scale testing with greater diversity is indicated. Conclusions: Our pilot study supported our hypothesis that the forearm CPR method was not inferior to the standard method with respect to time to fatigue. Having the mannequin at hospital bed height likely influenced the effectiveness of both techniques, so ensuing studies will use a mannequin on the ground.