Does training on placing rescuer's hands on victim's chest have an impact on the depth and frequency of chest compressions?

Dear Sir

During five Basic Life Support – Automatic External Defibrillator (BLS – AED) seminars a survey comprising 102 persons over the impact of rescuers’ hands placement on the quality of chest compressions was organized.

Participants were asked to perform four cycles of cardiopulmonary resuscitation (CPR) on a manikin in two different scenarios. First, participants were asked to perform CPR in a typical manner. Second, CPR was performed with a mark indicating rescuers’ proper hands position.

Timing for two scenarios were 60 ± 7 s (43–83 s) and 60 ± 5.75 seconds (47–81 s). In both scenarios 61% exceeded 1 min. Concerning quality of the compressions, at first scenario 88% achieved adequate compression depth while at the second 100%. Existence of the indication mark is correlated with better performance (r = 0.591, p < 0.01). Existence of the indicator did not change mean time but reduced standard deviation and increased participants’ achievement of adequate depth.

Further data analysis revealed negative correlation of female sex with adequate depth (r = −0.306, p < 0.01). Older age is correlated with longer timing (r = 0.196, p < 0.05) and adequate depth achievements (r = 0.216, p < 0.05). Previous attendance is correlated with worse timing performance (p = 0.04) but also adequate depth achievement (r = 0.287, p < 0.01).

Hand position during CRP is an issue concerning a variety of studies. ERC guidelines recommend as appropriate the lower half on the sternum (Koster et al. 2010) alongside with teaching in a simplified manner. This is reasonable since more complex guidelines, such as the ones of 2000 could potentially lead to bad positioning as shown by Owen et al. (2011) in a study comparing 2000 and 2005 guidelines.