The impact of backboard size and orientation on sternum-to-spine compression depth and compression stiffness in a manikin study of CPR using two mattress types

Abstract

Objectives To explore how backboard orientation and size impact chest compressions during cardiopulmonary resuscitation (CPR). Methods Experiments were conducted on a full-body CPR training manikin using a custom-built simulator. Two backboards of different sizes were tested in longitudinal (head to toe) and latitudinal (side to side) directions to assess the impact of size and orientation on chest compressions during CPR. The net sternum-to-spine displacement, combined mattress and sternal displacement as well as the axial reaction force were measured during each test. Results The difference in net compression depth between the larger and smaller backboards ranged between 0.08 ± 0.30 cm and 1.47 ± 0.13 cm, while the difference in back support stiffness varied between 103.7 ± 211 N/cm and 688.1 ± 180.3 N/cm. The difference in net compression depth between the longitudinal and latitudinal backboard orientations ranged from 0.07 ± 0.32 cm to 0.34 ± 0.18 cm, while for the back support stiffness the difference was between 13.4 ± 50.0 N/cm and 592.2 ± 211.0 N/cm. Conclusions The effect of backboard size on chest compression (CC) performance during CPR was found to be significant with the larger backboard producing deeper chest compressions and higher back support stiffness than the smaller backboard. The impact of backboard orientation was found to depend on the size of the backboard and type of mattress used. Clinicians should be aware that although a smaller backboard may be easier for rescuers to manipulate, it does not provide as effective back support or produce as deep chest compressions as a larger backboard.