Document Detail

Instructions to "push as hard as you can" improve average chest compression depth in dispatcher-assisted cardiopulmonary resuscitation.
MedLine Citation:
PMID:  18635306     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Cardiopulmonary resuscitation (CPR) with adequate chest compression depth appears to improve first shock success in cardiac arrest. We evaluate the effect of simplification of chest compression instructions on compression depth in dispatcher-assisted CPR protocol. METHODS: Data from two randomized, double-blinded, controlled trials with identical methodology were combined to obtain 332 records for this analysis. Subjects were randomized to either modified Medical Priority Dispatch System (MPDS) v11.2 protocol or a new simplified protocol. The main difference between the protocols was the instruction to "push as hard as you can" in the simplified protocol, compared to "push down firmly 2in. (5cm)" in MPDS. Data were recorded via a Laerdal ResusciAnne SkillReporter manikin. Primary outcome measures included: chest compression depth, proportion of compressions without error, with adequate depth and with total release. RESULTS: Instructions to "push as hard as you can", compared to "push down firmly 2in. (5cm)", resulted in improved chest compression depth (36.4 mm vs. 29.7 mm, p<0.0001), and improved median proportion of chest compressions done to the correct depth (32% vs. <1%, p<0.0001). No significant difference in median proportion of compressions with total release (100% for both) and average compression rate (99.7 min(-1) vs. 97.5 min(-1), p<0.56) was found. CONCLUSIONS: Modifying dispatcher-assisted CPR instructions by changing "push down firmly 2in. (5cm)" to "push as hard as you can" achieved improvement in chest compression depth at no cost to total release or average chest compression rate.
Muzna Mirza; Todd B Brown; Devashish Saini; Tracy L Pepper; Hari Krishna Nandigam; Niroop Kaza; Stacey S Cofield
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-07-17
Journal Detail:
Title:  Resuscitation     Volume:  79     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-22     Completed Date:  2009-01-27     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  97-102     Citation Subset:  IM    
Health Informatics Program, School of Health Professions, University of Alabama at Birmingham, USA.
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MeSH Terms
Cardiopulmonary Resuscitation / education*
Double-Blind Method
Heart Massage / methods*
Prospective Studies
Reinforcement, Verbal*
Grant Support
5-U01-HL077881/HL/NHLBI NIH HHS; N01 LM3-3513/LM/NLM NIH HHS; N01-LM-3-3513/LM/NLM NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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