• Am J Emerg Med · Jul 2015

    Randomized Controlled Trial

    Compressing with dominant hand improves quality of manual chest compressions for rescuers who performed suboptimal cardiopulmonary resuscitation in manikins.

    • Juan Wang, Ce Tang, Lei Zhang, Yushun Gong, Changlin Yin, and Yongqin Li.
    • Emergency Department, Southwest Hospital, Third Military Medical University, Chongqing 400038, China; Medical Training Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
    • Am J Emerg Med. 2015 Jul 1; 33 (7): 931-6.

    ObjectiveThe question of whether the placement of the dominant hand against the sternum could improve the quality of manual chest compressions remains controversial. In the present study, we evaluated the influence of dominant vs nondominant hand positioning on the quality of conventional cardiopulmonary resuscitation (CPR) during prolonged basic life support (BLS) by rescuers who performed optimal and suboptimal compressions.MethodsSix months after completing a standard BLS training course, 101 medical students were instructed to perform adult single-rescuer BLS for 8 minutes on a manikin with a randomized hand position. Twenty-four hours later, the students placed the opposite hand in contact with the sternum while performing CPR. Those with an average compression depth of less than 50 mm were considered suboptimal.ResultsParticipants who had performed suboptimal compressions were significantly shorter (170.2 ± 6.8 vs 174.0 ± 5.6 cm, P = .008) and lighter (58.9 ± 7.6 vs 66.9 ± 9.6 kg, P < .001) than those who performed optimal compressions. No significant differences in CPR quality were observed between dominant and nondominant hand placements for these who had an average compression depth of greater than 50 mm. However, both the compression depth (49.7 ± 4.2 vs 46.5 ± 4.1 mm, P = .003) and proportion of chest compressions with an appropriate depth (47.6% ± 27.8% vs 28.0% ± 23.4%, P = .006) were remarkably higher when compressing the chest with the dominant hand against the sternum for those who performed suboptimal CPR.ConclusionsChest compression quality significantly improved when the dominant hand was placed against the sternum for those who performed suboptimal compressions during conventional CPR.Copyright © 2015 Elsevier Inc. All rights reserved.

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