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The effects of bed height and time on the quality of chest compressions delivered during cardiopulmonary resuscitation
Emergency Medicine Journal, 09/06/2011
Lewinsohn A et al. – The most effective bed height position, allowing cardiopulmonary resuscitation (CPR) providers to achieve the highest intrathoracic pressures during CPR, was one where the patient's chest was in line with the CPR provider's mid–thigh. The provider performing CPR should change every 2 min.
Methods- A modified Laerdal manikin was connected to a Dragor ventilator (to measure intrathoracic pressures generated).
- The manikin was placed on a hospital trolley and CPR was performed by candidates at three different bed heights in a randomised order:
- Mid-thigh
- Anterior superior iliac spine
- Xiphisternum
- Chest compressions were continuous and asynchronous with ventilation, and were allowed to continue for 30 s before recordings were taken.
- At the anterior superior iliac spine level, chest compressions were continued for 2 min, when further measurements were taken.
- 101 subjects took part.
- The differences in intrathoracic pressures generated at different bed heights were compared using analysis of variance testing for multiple groups and were statistically significant for p<0.05.
- The authors also found that the effectiveness of CPR decreased 17% over a 2-minute period (p<0.05).
