title: Protective athletic equipment slows initiation of CPR in simulated cardiac arrest.
abstract: OBJECTIVE
  Standard protective athletic equipment used in collision sports such as American football poses a unique challenge to rescuers because they block access to both the airway and chest. The main objective of this investigation was to determine the effect of athletic equipment on the initiation of CPR. The feasibility of performing compressions over the chest protector as a potential time-saving step was also evaluated.
  
  
  METHODS
  Thirty-four certified athletic trainers performed CPR on a manikin wearing protective equipment during a simulated episode of cardiac arrest. For one trial the protective equipment was removed or unfastened prior to initiating CPR, and for another, chest compressions were initiated over the protective equipment. The following were recorded for comparison purposes: time until first breath and first compression; percentage of compressions delivered to the recommended depth; compression rate; accuracy of hand placement; percentage of compressions without full chest recoil.
  
  
  RESULTS
  Although chest compressions began sooner when compressions were delivered over the chest protector, this improvement was not statistically significant. A more notable positive outcome resulting from keeping the chest protector on was an increase in the number of compressions that were delivered to the recommended depth. Unfortunately, one of the significant negative outcomes of performing chest compression over the chest pad was the increased percentage of compressions that did not obtain full chest recoil.
  
  
  CONCLUSIONS
  Although removal of the chest protector delays the initiation of chest compressions, keeping the chest protector on during CPR does not appear to be a feasible option.
authors: University of South Florida, Tampa, FL 33612, USA. gdelross@health.usf.edu
authors: Gianluca
authors: G
authors: Del Rossi
authors: Daniel
authors: D
authors: Bodkin
authors: Aly
authors: A
authors: Dhanani
authors: Ron W
authors: RW
authors: Courson
authors: Jeff G
authors: JG
authors: Konin
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008348:Manikins; D011312:Pressure; D019876:Sports Equipment / Q000009:adverse effects*; D013909:Thorax