Abstract P150: Chest Compression Depth is Influenced by Compression Rate and Gender

Abstract

Purpose: Quality of chest compressions (CC) is an important determinant of resuscitation outcome for cardiac arrest patients. The purpose of this study was to characterize the quality of CC performed by hospital personnel and to evaluate for predictors of CC performance. Methods: A total of 754 individuals (488 nurses, 178 other healthcare professionals, 36 nursing students, and 52 non-healthcare professionals) participated in a CPR quality improvement challenge at 31 U.S. hospitals. Participants performed 2 minutes of CC on a manikin with an accelerometer-based system for measuring both rate (CC/min, cpm) and depth (in) of CC using the AED Plus (ZOLL Medical). Real-time audiovisual feedback normally available on the AED was disabled. Results: The mean depth of compressions was below AHA minimum guidelines (<1.5 in) for 34% of participants (1.30±0.14 in, n=255) and above maximum guidelines (>2.0 in) for 12% of participants (2.20±0.22 in, n=93). CC depth related inversely to CC rate (r=−0.37, p<0.0001), suggesting that excessive CC rate can contribute to insufficient CC depth. Male participants performed CC of greater depth compared with female participants [1.72±0.33 in (n=187) vs.1.60±0.31 (n=534), p<0.0001]. There were no differences in CC depth between ACLS, BCLS, and non-CPR certified participants [1.64±0.33 in (n=392) vs. 1.63±0.31 (n=278) vs. 1.58±0.23 (n=34); p=0.6]. However, depth of CC was greater for non-healthcare professionals compared with healthcare professionals [1.74±0.33 in (n=52) vs. 1.63±0.32 (n=702)]. CC depth varied slightly with rescuer age [<20yr= 1.82±0.27 in (n=8); 21–30 yr= 1.66±0.31 (n=177); 31–40 yr= 1.65±0.31 (n=204); 41–50 yr= 1.62±0.32 (n=196); 51–60yr= 1.54±0.29 (n=109); 61–70 yr= 1.63±0.47 (n=13), p=0.009]. Multivariate linear regression revealed that CC rate (r part =−0.37, p<0.001) and gender (r part = 0.15, p=0.001) were predictors of CC depth. Conclusions: Many hospital personnel do not perform CC within AHA guideline recommendations for depth. Depth of CC may be compromised when rescuers provide CC of excessive rate. Males provide CC of greater depth compared with females.