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{
    "pk": 9182,
    "title": "A Simulation-based Randomized Controlled Study of Factors Influencing Chest Compression Depth",
    "subtitle": null,
    "abstract": "Introduction:\n Current resuscitation guidelines emphasize a systems approach with a strong emphasis on quality cardiopulmonary resuscitation (CPR). Despite the American Heart Association (AHA) emphasis on quality CPR for over 10 years, resuscitation teams do not consistently meet recommended CPR standards. The objective is to assess the impact on chest compression depth of factors including bed height, step stool utilization, position of the rescuer’s arms and shoulders relative to the point of chest compression, and rescuer characteristics including height, weight, and gender.\nMethods:\n Fifty-six eligible subjects, including physician assistant students and first-year emergency medicine residents, were enrolled and randomized to intervention (bed lowered and step stool readily available) and control (bed raised and step stool accessible, but concealed) groups. We instructed all subjects to complete all interventions on a high-fidelity mannequin per AHA guidelines. Secondary end points included subject arm angle, height, weight group, and gender.\nResults:\n Using an intention to treat analysis, the mean compression depths for the intervention and control groups were not significantly different. Subjects positioning their arms at a 90-degree angle relative to the sagittal plane of the mannequin’s chest achieved a mean compression depth significantly greater than those compressing at an angle less than 90 degrees. There was a significant correlation between using a step stool and achieving the correct shoulder position. Subject height, weight group, and gender were all independently associated with compression depth. \nConclusion: \nRescuer arm position relative to the patient’s chest and step stool utilization during CPR are modifiable factors facilitating improved chest compression depth.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "cardiopulmonary resuscitation"
        },
        {
            "word": "chest compression depth"
        },
        {
            "word": "heart massage"
        },
        {
            "word": "Simulation"
        },
        {
            "word": "acls"
        }
    ],
    "section": "Critical Care",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/0374238b",
    "frozenauthors": [
        {
            "first_name": "Kelsey",
            "middle_name": "P.",
            "last_name": "Mayrand",
            "name_suffix": "",
            "institution": "Boonshoft School of Medicine, Wright State University, Fairborn, Ohio",
            "department": "None"
        },
        {
            "first_name": "Eric",
            "middle_name": "J.",
            "last_name": "Fischer",
            "name_suffix": "",
            "institution": "Boonshoft School of Medicine, Wright State University, Fairborn, Ohio",
            "department": "None"
        },
        {
            "first_name": "Raymond",
            "middle_name": "P.",
            "last_name": "Ten Eyck",
            "name_suffix": "",
            "institution": "Boonshoft School of Medicine, Wright State University, Fairborn, Ohio",
            "department": "None"
        }
    ],
    "date_submitted": "2015-07-18T18:55:01Z",
    "date_accepted": "2015-07-18T18:55:01Z",
    "date_published": "2015-11-14T00:13:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/9182/galley/5167/download/"
        }
    ]
}