Magical manoeuvre: a 5-s instructor's intervention helps lightweight female rescuers achieve the required chest compression depth.
BACKGROUND
Adequate chest compression (CC) depth is crucial for resuscitation outcomes. Lightweight rescuers, particularly women, are often unable to achieve the required 5-6 cm CC depth. This nonrandomized cohort study investigated new strategies to improve CC performance.


OBJECTIVE
To evaluate the effects of a 5-s instructor's intervention on the depth of CCs performed by female rescuers during standard video self-instruction basic life support training.


METHODS
Data were prospectively collected from January 2011 to January 2012 from 336 female medical and pharmacy students undergoing cardiopulmonary resuscitation (CPR) training at the Lithuanian University of Health Sciences. During the training process, the instructors performed a simple 5-s intervention (Andrew's manoeuvre) with all of the rescuers in the study group. The instructor pushed 10 times on the shoulders of each trainee while she performed CCs to achieve the maximal required compression depth. Immediately after training, the participants were asked to perform a 6-min basic life support test on a manikin that was connected to a PC with Skill Reporter System software; the quality of the participants' CPR skills was then evaluated.


RESULTS
The CC depth in the study group increased by 6.4 mm (P<0.001) compared with the control group (52.9 vs. 46.6 mm). A regression analysis showed that Andrew's manoeuvre increased the depth of the CCs among women by 14.87×(1-0.01×weight) mm.


CONCLUSIONS
A simple 5-s instructor's intervention during the CPR training significantly improved the performance of the female rescuers and helped them achieve the CC depth required by 2010 resuscitation guidelines. Andrew's manoeuvre is most effective among the women with the lowest body weight.
Departments of aDisaster Medicine bIntensive Care, Crises Research Centre cDepartment of Surgery, Lithuanian University of Health Sciences dHospital of Lithuanian University of Health Sciences Kaunas Clinics eDepartment of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Kaunas, Lithuania.
Asta
A
Krikscionaitiene
Andrius
A
Pranskunas
Kestutis
K
Stasaitis
Milda
M
Dambrauskiene
Nedas
N
Jasinskas
Zilvinas
Z
Dambrauskas
Egle
E
Vaitkaitiene
Jone
J
Vencloviene
Dinas
D
Vaitkaitis
D000328:Adult; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008020:Life Support Care; D008348:Manikins