• Aurélien Marquis, Delphine Douillet, François Morin, Damien Chauvat, Aurélien Sechet, Hélène Lacour, Laurent Poiroux, and Dominique Savary.
• Centre for Emergency Care Teaching (CESU 49), Angers University Hospital, Angers, France.
• Am J Emerg Med. 2023 Dec 1; 74: 9139-13.

BackgroundPerforming quality chest compressions is fundamental to the management of cardiopulmonary arrest. The aim of this study was to compare the efficacy of two hand positions: overlapping versus interlocking for performing chest compressions during cardiopulmonary arrest.MethodsThe HP2C (for Hands Position and Chest Compression) was a prospective, randomised, open-label, cross-over, single-centre study. Participants were recruited from the Emergency Medical Service (EMS) teams and the prehospital firefighter teams. They were randomised to start chest compressions either with overlapping or interlocking hands and then performed the other technique after a washout period. The judgement criteria were the overall chest compressions success score generated by software in accordance with ILCOR recommendations, the quality of compression, release, rate and subjective intensity measured with the Borg scale.ResultsA total of 100 participants were included in the study. The mean age of the caregivers was 38 ± 9.3 years. The median CPR score was 79.5% IQR [48.5-94.0] in the overlapping hands group and 71% IQR [38.0-92.8] in the interlocking hands group (p-value = 0.37). There was no significant difference for the other criteria, especially no difference in term of intensity of effort. However, there was a trend towards better results with overlapping hands.ConclusionsThis study failed to demonstrate a difference in effectiveness between overlapping and interlocking hand chest compressions during cardiopulmonary resuscitation.Copyright © 2023 Elsevier Inc. All rights reserved.

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