Comparison of chest compression kinematics associated with over-the-head and standard cardiopulmonary resuscitation

• Published in: The American journal of emergency medicine Vol. 27; no. 9; pp. 1112 - 1116
• Main Authors: Chi, Chih-Hsien, Tsou, Jui-Yi, Su, Fong-Chin
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2009; Elsevier; Elsevier Limited
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biomechanical Phenomena; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Confined spaces; CPR; Cross-Over Studies; Emergency; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Emergency medical care; Female; Heart attacks; Humans; Intensive care medicine; Kinematics; Load distribution; Male; Medical sciences; Physical Exertion; Posture - physiology; Range of Motion, Articular - physiology; Studies; Task Performance and Analysis; Variance analysis; Weight-Bearing - physiology; Young Adult; Intensive care; Head; Comparative study; Resuscitation
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2008.08.029

Over-the-head cardiopulmonary resuscitation (CPR) is a method of chest compression, which may be easier to perform than standard CPR in a confined space. The purpose of this study was to evaluate the effects of over-the-head CPR on the kinematics and the force of delivered compressions. The subjects were 21 health care providers who were experienced in CPR. Each participant performed over-the-head CPR (O) and standard CPR (S). The compression-to-ventilation ratio was 30:2. The CPR duration was 2 minutes in each position, with a rest period of 15 minutes between each instance. The order in which positions were adopted was randomized. A manikin was equipped with a 6-axial force load cell to collect 3-dimensional compression forces at a sampling rate of 1000 Hz. An 8-camera digital motion analysis system was used to collect 3-dimensional trajectory information. Data were compared by crossover design analysis of variance ( P < .05 represents statistical significance). No significant differences in range of motion of the head, shoulder, lower trunk, hip, and knee were obtained using the 2 methods. The compression forces in O and S were 386.64 ± 47.32 and 397.35 ± 41.89 N, respectively ( P > .05). No significant differences between the compression frequencies, depths, and percentages correct were obtained using the 2 methods. There were no differences between the kinematics, compression forces, depths, and frequencies obtained using the O and S CPR methods as practiced by experienced providers.