• Gavin D Perkins, Laura Kocierz, Samuel C L Smith, Robert A McCulloch, and Robin P Davies.
• Warwick Medical School, University of Warwick, Warwick CV4 7AL, United Kingdom. g.d.perkins@warwick.ac.uk
• Resuscitation. 2009 Jan 1;80(1):79-82.

IntroductionCPR feedback/prompt devices are being used increasingly to guide CPR performance in clinical practice. A potential limitation of these devices is that they may fail to measure the amount of mattress compression when CPR is performed on a bed. The aim of this study is to quantify the amount of mattress compression compared to chest compression using a commercially available compression sensor (Q-CPR, Laerdal, UK). A secondary aim was to evaluate if placing a backboard beneath the victim would alter the degree of mattress compression.MethodsCPR was performed on a manikin on the floor and on a bed with a foam or inflatable mattress with and without a backboard. Chest and mattress compression depths were measured by an accelerometer placed on the manikin's chest (total compression depth) and sternal-spinal (chest) compression by manikin sensors.ResultsFeedback provided by the accelerometer device led to significant under compression of the chest when CPR was performed on a bed with a foam 26.2 (2.2)mm or inflatable mattress 32.2 (1.16)mm. The use of a narrow backboard increased chest compression depth by 1.9mm (95% CI 0.1-3.7mm; P=0.03) and wide backboard by 2.6mm (95% CI 0.9-4.5mm; P=0.013). Under compression occurred as the device failed to compensate for compression of the underlying mattress, which represented 35-40% of total compression depth.ConclusionThe use of CPR feedback devices that do not correct for compression of an underlying mattress may lead to significant under compression of the chest during CPR.

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