Further proof

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A randomised controlled trial comparing two techniques
for locating chest compression hand position in adult
Basic Life Support (BLS)

Presenting author:
Dr Andrew Owen
Foundation Year 2 Doctor
University of Birmingham
Other authors:
P Harvey, J Hulme, L Kocierz, A Lewis, J Walters

ABSTRACT:

Aims: Chest compressions can increase survival after cardiac arrest. European Resuscitation Council (ERC) 2005 guidelines simplified the hand position technique aiming to increase effective compressions. This randomised controlled trial compares chest compression efficacy using the 2005 guidelines, with and without, additional landmark teaching.

Methodology: 82 first-year healthcare students at the University of Birmingham, UK, were randomised to ‘control’ (41) or ‘intervention’ (41) groups after passing an ERC BLS assessment. The intervention group received additional landmark training as per the 2005 ERC guidelines, using the costal margin and midline to locate the correct hand position, but emphasising minimal delay in chest compressions. Both groups then performed 2 minutes of BLS on skill-reporter manikins with additional subjective assessment by experienced instructors.

Results: Control and intervention average compression rates were 103 and 105 per minute respectively (p=0.29). The average number of incorrect hand placements, assessed by the skill-reporter manikin, were 24 and 8.9 respectively (p=0.03). There were no significant differences in compression depth or duty cycle from manikin recordings or incorrect hand placements judged by instructors.

Conclusion: Using simplified hand positioning instructions with additional teaching of a rapid landmark technique for chest compressions improves hand positioning without reducing the number of effective chest compressions performed during BLS.