title: Use of step stool during resuscitation improved the quality of chest compression in simulated resuscitation.
abstract: OBJECTIVE
  Resuscitation on a medical bed is difficult because of the need to match the height of the bed to the height of the rescuer, which is impossible on a fixed-height medical bed. This study investigated the effect of using a step stool on chest compressions performed on a manikin in a fixed-height medical bed.
  
  
  METHODS
  This prospective, observational study was performed using simulated resuscitation manikins and a fixed-height (78 cm) medical bed. Chest compression-ventilation of more than five cycles was performed with and without a 20-cm-high step stool. A total of 74 medical students participated in this study. The quality of the chest compressions was examined using the Laerdal PC Skill Reporting System. The angle between the arm of the rescuer and the bed was measured. In addition, whether the heels of the rescuer reached the ground during the compressions was assessed using lateral-view pictures.
  
  
  RESULTS
  Use of the step stool improved the quality of the chest compressions with regard to depth, proper compressions, insufficient compressions and incorrect hand position (P < 0.05). The angle between the rescuer's arm and bed during the chest compressions was closer to vertical with the use of the step stool than without it (average angle, 83.84 ± 4.16° and 73.41 ± 9.16°, respectively; P < 0.001).
  
  
  CONCLUSIONS
  In-hospital resuscitation was conducted on a fixed-height medical bed by rescuers of different heights. The use of a step stool may improve the quality and effectiveness of chest compressions, particularly for short rescuers.
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chungang University, Seoul, Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Lee
authors.forename: Chan Woong
authors.initials: CW
authors.lastname: Kim
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D008297:Male; D008348:Manikins; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards; D055815:Young Adult