A comparison between over-the-head and standard cardiopulmonary resuscitation performed by two rescuers: a simulation study.
The Journal of emergency medicine · 2009-06-04 · Randomised trial
Abstract
BACKGROUND: In cardiopulmonary resuscitation (CPR) of a patient with an unsecured airway performed by two health care professionals, two methods are possible: 1) Standard CPR according to the guidelines, with one rescuer performing chest compressions from the side and the other rescuer performing ventilations from over the head of the patient. Additional tasks (like attaching the electrocardiogram and defibrillator) must be performed by the second rescuer during the time between ventilations. 2) Over-the-head CPR, with one rescuer performing chest compressions and ventilations from over the head and the other rescuer performing additional tasks. OBJECTIVES: The aim of this study was to compare the quality of CPR achieved by the two methods. METHODS: After a standardized theoretical introduction and practical training, 106 medical students with limited knowledge and training in CPR participated in this randomized crossover study. Students performed a 2-min CPR test of standard CPR in both positions and over-the-head CPR alone on a manikin. RESULTS: Standard CPR led to a significantly shorter hands-off-time over a 2-min interval than over-the-head CPR (median 25 s [interquartile range (IQR) 22-26 s] vs. 38 s [IQR 36-43 s], respectively, p < 0.001), and significantly more chest compressions (167 [IQR 158-176] vs. 142 [IQR 132-150], respectively, p < 0.001), more correct chest compressions (72 [IQR 11-136] vs. 45 [IQR 13-88], respectively, p = 0.004), inflations (10 [IQR 10-10] vs. 8 [IQR 8-8], respectively, p < 0.001), and correct inflations (5 [IQR 2-7] vs. 3 [IQR 1-4], respectively, p < 0.001). CONCLUSIONS: In the case of a two-professional-rescuer CPR scenario, standard CPR enables a quantitatively better resuscitation than over-the-head CPR.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Bag-valve-mask ventilation · Students
Related articles
- Analysis of the adequacy of infant cardiopulmonary resuscitation according to chest compression technique based on the 2020 AHA guidelines (Signa Vitae, 2022)
- CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial. (Scand J Trauma Resusc Emerg Med, 2021)
- Effect of flashlight guidance on manual ventilation performance in cardiopulmonary resuscitation: A randomized controlled simulation study. (PLoS One, 2018)
- Two-Thumb Encircling Technique Over the Head of Patients in the Setting of Lone Rescuer Infant CPR Occurred During Ambulance Transfer: A Crossover Simulation Study. (Pediatr Emerg Care, 2017)
- Usefulness of the compression-adjusted ventilation for adequate ventilation rate during cardiopulmonary resuscitation. (Am J Emerg Med, 2014)
- Bag-mask ventilation and direct laryngoscopy versus intubating laryngeal mask airway: a manikin study of hands-on times during cardiopulmonary resuscitation. (Eur J Emerg Med, 2014)