title: The effect of inclined step stool on the quality of chest compression during in-hospital cardiopulmonary resuscitation.
abstract: OBJECTIVE
  A step stool is an ordinary device to improve the quality of chest compression (CC) during in-hospital cardiopulmonary resuscitation (CPR). We investigated the effect of an inclined step stool on the quality of CC during CPR on a hospital bed.
  
  
  METHODS
  We conducted a randomized crossover study of simulation using a manikin. Two different methods of CC were performed and compared: CC using a flat stool and CC using an inclined (20°) stool. Each session of CC was performed for 2 minutes using a metronome at a rate of 110 beats per minute. The primary outcome was the depth of CC. The adequate CC rate, duty cycle, rate of incomplete recoil, and the angle between the arm of the participants and the bed were also measured.
  
  
  RESULTS
  The median value of the mean depth of CC was 50.5 mm (45.0-57.0 mm) in the flat stool group and 54.5 mm (47.0-58.3 mm) in the inclined stool group (P = .014). The adequate CC rate was significantly higher in the inclined stool group (84.2% [37.6%-99.1%] vs 57.0% [15.2%-95.0%]; P = .016). The duty cycle and the rate of incomplete recoil were comparable between the 2 groups. The angles between the arm of the participants and the bed were more vertical in the inclined stool group (84.0° ± 5.2° vs 81.0° ± 4.8°; P = .014).
  
  
  CONCLUSIONS
  Using an inclined stool resulted in an improvement in the depth of CC and the adequate CC rate without increasing the rate of incomplete chest recoil.
authors.affiliation: Department of Emergency Medical Technology, Namseoul University, 91 Daehak-ro, Sebuk-gu, Cheonan, Republic of Korea.
authors.forename: Seong-Woo
authors.initials: SW
authors.lastname: Yun
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea. Electronic address: bbukkuk@hanmail.net.
authors.forename: Byung Kook
authors.initials: BK
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
authors.forename: Kyung Woon
authors.initials: KW
authors.lastname: Jeung
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Choi
authors.affiliation: Department of Emergency Medical Technology, Namseoul University, 91 Daehak-ro, Sebuk-gu, Cheonan, Republic of Korea.
authors.forename: Chang-Hee
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Health Science, Graduate School of Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, Republic of Korea.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Ryu
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods; D018592:Cross-Over Studies; D005260:Female; D006336:Heart Massage / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008348:Manikins; D011187:Posture; D016896:Treatment Outcome; D055815:Young Adult