title: Quality of cardiopulmonary resuscitation on manikins: on the floor and in the bed.
abstract: BACKGROUND
  In general, in-hospital resuscitation is performed in a bed and out-of-hospital resuscitation on the floor. The surface under the patient may affect the cardiopulmonary resuscitation (CPR) quality; therefore, we evaluated CPR quality (the percentage of chest compressions of correct depth) and rescuer's fatigue (the mean compression depth minute by minute) when CPR is performed on a manikin on the floor or in the bed.
  
  
  METHODS
  Forty-four simulated cardiac arrest scenarios of 10 min were treated by intensive care unit (ICU) nurses in pairs using a 30 : 2 chest compression-to-ventilation ratio. The rescuer who performed the compressions was changed every 2 min. CPR was randomly performed either on the floor or in the bed without a backboard; in both settings, participants kneeled beside the manikin.
  
  
  RESULTS
  A total number of 1060 chest compressions, 44% with correct depth, were performed on the floor; 1068 chest compressions were performed in the bed, and 58% of these were the correct depth. These differences were not significant between groups. The mean compression depth during the scenario was 44.9+/-6.2 mm (mean+/-SD) on the floor and 43.0+/-5.9 mm in the bed (P=0.3). The mean chest compression depth decreased over time on both surfaces (P<0.001), indicating rescuer fatigue, but this change was not different between the groups (P=0.305).
  
  
  CONCLUSIONS
  ICU nurses perform chest compression as effectively on the floor as in the bed. The mean chest compression depth decreases over time, but the surface had no significant effect.
authors.affiliation: Department of Anaesthesia and Intensive Care, Kuopio University Hospital, Kuopio, Finland. helena.jantti@kuh.fi
authors.forename: H
authors.initials: H
authors.lastname: Jäntti
authors.forename: T
authors.initials: T
authors.lastname: Silfvast
authors.forename: A
authors.initials: A
authors.lastname: Turpeinen
authors.forename: V
authors.initials: V
authors.lastname: Kiviniemi
authors.forename: A
authors.initials: A
authors.lastname: Uusaro
mesh_terms: D000328:Adult; D001513:Beds; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003625:Data Collection; D003627:Data Interpretation, Statistical; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged; D018763:Muscle Fatigue / Q000502:physiology; D009726:Nurses; D011312:Pressure