title: Effects of a backboard, bed height, and operator position on compression depth during simulated resuscitation.
abstract: OBJECTIVE
  To investigate the effect of a backboard, cardiopulmonary resuscitation (CPR) provider body position and bed height on the quality of chest compression during simulated in-hospital resuscitation.
  
  
  METHODS
  Randomised controlled cross-over trial in a university hospital.
  
  
  METHODS
  Second-year medical student basic life support instructors.
  
  
  METHODS
  Chest compressions performed on a resuscitation manikin placed on a hospital bed with/without a CPR backboard, kneeling on the bed adjacent to the manikin and lowering the height of the bed.
  
  
  RESULTS
  Sub-optimal chest compressions were performed on all surfaces. There were no differences in compression depth: standard CPR, 29+/-7 mm; backboard CPR, 31+/-10 mm; kneeling on the bed, 30+/-7 mm; lowering bed height, 32+/-10 mm. Compression rate and duty cycle were similar on each surface. Participants failed to recognise their poor quality CPR, and there was no difference in assessment of fatigue or efficacy of CPR between surfaces.
  
  
  CONCLUSIONS
  In contrast to current guidelines, the use of a CPR backboard did not improve chest compressions. Furthermore, kneeling on the bed adjacent to the victim or lowering bed height did not impact materially on the quality of chest compression. These findings should be validated in clinical studies.
authors.affiliation: University of Birmingham, Division of Medical Sciences, B15 2TT Birmingham, UK. gavin.perkins@virgin.net
authors.forename: Gavin D
authors.initials: GD
authors.lastname: Perkins
authors.forename: Chris M
authors.initials: CM
authors.lastname: Smith
authors.forename: Colette
authors.initials: C
authors.lastname: Augre
authors.forename: Michael
authors.initials: M
authors.lastname: Allan
authors.forename: Helen
authors.initials: H
authors.lastname: Rogers
authors.forename: Barney
authors.initials: B
authors.lastname: Stephenson
authors.forename: David R
authors.initials: DR
authors.lastname: Thickett
mesh_terms: D000704:Analysis of Variance; D001513:Beds; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods*; D018592:Cross-Over Studies; D004867:Equipment Design; D006801:Humans; D008348:Manikins; D011187:Posture; D011312:Pressure