Chest compression using the foot or hand method: a prospective, randomized, controlled manikin study with school children.

Abstract

Maintaining a chest compression depth of 5 cm or more as specified by resuscitation guidelines is difficult. Historical studies have shown an advantage of the foot method (FM) over the hand method (HM) in participants weighing less than 50 kg. Because of the fact that the importance of chest compression is increasing from guideline to guideline, the FM technique had not been evaluated conclusively and worldwide resuscitation is taught to school children, we investigated whether school children achieved a higher quality of chest compression with the FM than with the HM. A total of 105 school children, aged 12 to 15 years, were randomized to an FM or an HM resuscitation group. After a 3 min training video, 5 min of practice, and a 5 min latent time, the participants performed a 2 min sequence of chest compressions, which was recorded on a PC and evaluated later. The mean percentage of correct chest compression depth (primary endpoint) was low in both groups (HM 45%, FM 47%, P=0.76). This was also found for those weighing less than 50 kg and at least 50 kg in both groups (FM 23%, HM 34%, P=0.2; FM 62%, HM 56%, P=0.57). However, the HM group was better in frequency (98 vs. 86% in FM, P=0.03) and complete decompression (99 vs. 91% in FM, P≤0.001). The FM of applying chest compression did not result in a more accurately delivered compression depth compared with the HM for children and adolescents, irrespective of body weight.