The capability of professional- and lay-rescuers to estimate the chest compression-depth target: A short, randomized experiment

• Published in: Resuscitation Vol. 89; pp. 137 - 141
• Main Authors: van Tulder, Raphael, Laggner, Roberta, Kienbacher, Calvin, Schmid, Bernhard, Zajicek, Andreas, Haidvogel, Jochen, Sebald, Dieter, Laggner, Anton N, Herkner, Harald, Sterz, Fritz, Eisenburger, Philip
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.04.2015
• Subjects: Adult; Cardiac arrest; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - education; Chest compression; Clinical Competence; Emergency; Emergency Responders; Female; Heart Arrest - therapy; Heart Massage; Humans; Male; Manikin; Manikins; Middle Aged; Quality of Health Care; Reproducibility of Results; Young Adult; Chest compression; Manikin; Cardiopulmonary resuscitation; Cardiac arrest
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2015.01.031

Abstract Background In CPR, sufficient compression depth is essential. The American Heart Association (“at least 5 cm”, AHA-R) and the European Resuscitation Council (“at least 5 cm, but not to exceed 6 cm”, ERC-R) recommendations differ, and both are hardly achieved. This study aims to investigate the effects of differing target depth instructions on compression depth performances of professional and lay-rescuers. Methods 110 professional-rescuers and 110 lay-rescuers were randomized (1:1, 4 groups) to estimate the AHA-R or ERC-R on a paper sheet (given horizontal axis) using a pencil and to perform chest compressions according to AHA-R or ERC-R on a manikin. Distance estimation and compression depth were the outcome variables. Results Professional-rescuers estimated the distance according to AHA-R in 19/55 (34.5%) and to ERC-R in 20/55 (36.4%) cases ( p = 0.84). Professional-rescuers achieved correct compression depth according to AHA-R in 39/55 (70.9%) and to ERC-R in 36/55 (65.4%) cases ( p = 0.97). Lay-rescuers estimated the distance correctly according to AHA-R in 18/55 (32.7%) and to ERC-R in 20/55 (36.4%) cases ( p = 0.59). Lay-rescuers yielded correct compression depth according to AHA-R in 39/55 (70.9%) and to ERC-R in 26/55 (47.3%) cases ( p = 0.02). Conclusion Professional and lay-rescuers have severe difficulties in correctly estimating distance on a sheet of paper. Professional-rescuers are able to yield AHA-R and ERC-R targets likewise. In lay-rescuers AHA-R was associated with significantly higher success rates. The inability to estimate distance could explain the failure to appropriately perform chest compressions. For teaching lay-rescuers, the AHA-R with no upper limit of compression depth might be preferable.