• Je Hyeok Oh, Hyeonseok Noh, Jun Gyu Lee, and Don-Kyu Kim.
• Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea. Electronic address: jehyeokoh@cau.ac.kr.
• Am J Emerg Med. 2022 Sep 1; 59: 242924-29.

ObjectiveThe posture of the rescuer while performing the one-handed chest compression (OHCC) has not yet been evaluated. This study aimed to investigate the effect of vertical compression during pediatric cardiopulmonary resuscitation (CPR) using the OHCC technique.MethodsThis was a prospective randomized crossover simulation trial. A total of 42 medical doctors conducted a 2-min single-rescuer CPR using the conventional OHCC (Test 1) or vertical OHCC (Test 2) technique on a pediatric manikin. The chest compression and ventilation parameters were measured in real time during the experiments using sensors embedded in the manikin. In addition, the compression force of each technique was measured using a force plate.ResultsThe average and adequate chest compression depth (CCD) were significantly higher in Test 2 than in Test 1 (average depth: 54.0 mm (interquartile range [IQR]: 48.5-56.0) in Test 2 vs. 49.0 mm (IQR: 40.0-54.0) in Test 1, P < 0.001; adequate depth: 99.0% (IQR: 36.3-100.0) in Test 2 vs. 52.0% (IQR: 0.0-98.0) in Test 1, P < 0.001). The average force of compression was also significantly higher in vertical OHCC than that in conventional OHCC (25.7 kg ± 4.4 in vertical OHCC vs. 24.5 kg ± 4.2 in conventional OHCC, P < 0.001). The ventilation parameters were not significantly different between Tests 1 and 2.ConclusionsThe vertical OHCC could provide a deeper and more adequate CCD compared with the conventional OHCC, and the advantages of the vertical OHCC originate from the superiority of the compression force.Copyright © 2022 Elsevier Inc. All rights reserved.

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