The Effects of the Use of Inclined Stool on the Quality of Chest Compression During Cardiopulmonary Resuscitation

Objective: The chest compression (CC) is the most important factor in cardiopulmonary resuscitation (CPR) practice. A stool was an ordinary device to improve the quality of CC during in-hospital CPR. We investigated whether the inclined stool improved the quality of CC.

Method: Study design of this study was a randomized crossover study of simulation using a manikin. Two different method of CC were performed and compared: CC using a flat stool or CC using an inclined (20°) stool. Each session of CC was performed for 2 min using a metronome at a rate of 110/min. The primary outcome was the depth of CC. The CC rate, adequate CC rate, compression to recoil ratio, incomplete recoil rate, angle between the arm of the rescuer and the bed were also measured. The fatigability and confidence of the subjects were measured by visual analogue scale.

Result : A total 22 subjects were enrolled. The angles between the arm of the rescuer and the bed were 81.0±4.8° in flat stool group and 84.0±5.2° in inclined stool group(p=0.014). The mean depth of CC was 50.5±6.5 mm in flat stool group and 52.5±6.1 mm in inclined stool group (p=0.014). The adequate CC rate was significantly high in inclined stool group (55.8±36.3% vs. 67.6±34.9%, p=0.016). The compression to recoil ratio and the rate of incomplete recoil were not statistically between two groups. The subjects felt more tired during using the flat stool (7.8±0.9) than the inclined stool (4.7±1.6) (p<0.001). The confidence of performing CC was also higher in inclined stool group than in flat stool group(4.9±1.6 vs. 8.1±1.4, p<0.001).

Conclusion : The CC using inclined stool improved the depth of CC and adequate CC rate without increasing the fatigability. The further clinical trial is needed to confirm the effectiveness of inclined stool in CC quality.

key word: Cardiopulmonary resuscitation, Chest compression, Inclined stool, Flat stool, Quality