Abstract
Previous studies have shown improved external chest compression (ECC) quality and delayed rescuer fatigue when the dominant hand (DH) was in contact with the sternum. However, many rescuers prefer placing the non-dominant hand (NH) in contact with the sternum during ECC. We aimed to investigate the effects of up-down hand position switch on the quality of ECC and the fatigue of rescuers during cardiopulmonary resuscitation (CPR). After completion of a review of the standard adult basic life support (BLS) course, every candidate performed 10 cycles of single adult CPR twice on an adult manikin with either a constant hand position (CH) or a switched hand position (SH) in random order at 7-day intervals. The rescuers’ general characteristics, hand positions, physiological signs, fatigue appearance and ECC qualities were recorded. Our results showed no significant differences in chest compression quality for the DH position rescuers between the CH and SH sessions (p>0.05, resp.). And also no significant differences were found for Borg score (p = 0.437) or cycle number (p = 0.127) of fatigue appearance after chest compressions between the two sessions. However, for NH position rescuers, the appearance of fatigue was delayed (p = 0.046), with a lower Borg score in the SH session (12.67 ± 2.03) compared to the CH session (13.33 ± 1.95) (p = 0.011). Moreover, the compression depth was significantly greater in the SH session (39.3 ± 7.2 mm) compared to the CH session (36.3 ± 8.1 mm) (p = 0.015). Our data suggest that the up-down hand position switch during CPR may delay the fatigue of non-dominant hand position rescuers and improve the quality of chest compressions.
Highlights
High-quality cardiopulmonary resuscitation (CPR) is vital for survival after cardiac arrest (CA), and chest compressions are key to the performance of CPR [1]
We found that approximately 71% (155/220) of our novice rescuers preferred a non-dominant hand position during CPR [5]
The only characteristic that was significantly different between the dominant hand position group and the non-dominant hand position group was weight (DH vs. NH: 59 ± 12 vs. 55 ± 10 kg, p = 0.034) (Table 1)
Summary
High-quality cardiopulmonary resuscitation (CPR) is vital for survival after cardiac arrest (CA), and chest compressions are key to the performance of CPR [1] Several components, such as hand position, position of the victim, and position of the rescuer, can alter the quality of external chest compressions (ECC) [2]. Our recent manikin study based on current guidelines suggested that using the dominant hand position could improve ECC quality and delay the fatigue of novice rescuers [5]. No study has investigated the effects of up-down hand position switch during CPR on ECC quality or rescuer fatigue This manikin study was based on the 2010 American Heart Association (AHA) CPR guidelines and was designed to test our hypothesis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
