title: Effectiveness and feasibility of assistant push on improvement of chest compression quality: a crossover study.
abstract: OBJECTIVE
  To improve the quality of chest compression (CC), we developed the assistant-push method, whereby the second rescuer pushes the back of the chest compressor during CC. We investigated the effectiveness and feasibility of assistant push in achieving and maintaining the CC quality.
  
  
  METHODS
  This was a randomized crossover trial in which 41 subjects randomly performed both of standard CC (single-rescuer group) and CC with instructor-driven assistant push (assistant-push group) in different order. Each session of CC was performed for 2 minutes using a manikin. Subjects were also assigned to both roles of chest compressor and assistant and together performed CC with subject-driven assistant push. Depth of CC, compression to recoil ratio, duty cycle, and rate of incomplete recoil were quantified.
  
  
  RESULTS
  The mean depth of CC (57.0 [56.0-59.0] vs 55.0 [49.5-57.5], P < .001) was significantly deeper, and the compression force (33.8 [29.3-36.4] vs 23.3 [20.4-25.3], P < .001) was stronger in the assistant-push group. The ratio of compression to recoil, duty cycle, and rate of incomplete chest recoil were comparable between the 2 groups. The CC depth in the single-rescuer group decreased significantly every 30 seconds, whereas in the assistant-push group, it was comparable at 60- and 90-second time points (P = .004). The subject assistant-push group performed CCs at a depth comparable with that of the instructor assistant-push group.
  
  
  CONCLUSIONS
  The assistant-push method improved the depth of CC and attenuated its decline, eventually helping maintain adequate CC depth over time. Subjects were able to feasibly learn assistant push and performed effectively.
authors: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
authors: Sung Soo
authors: SS
authors: Choi
authors: Department of Emergency Medical Technology, Namseoul University, 91 Daehak-ro, Sebuk-gu, Cheonan, Republic of Korea.
authors: Seong-Woo
authors: SW
authors: Yun
authors: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea. Electronic address: bbukkuk@hanmail.net.
authors: Byung Kook
authors: BK
authors: Lee
authors: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
authors: Kyung Woon
authors: KW
authors: Jeung
authors: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
authors: Kyoung Hwan
authors: KH
authors: Song
authors: Department of Emergency Medical Technology, Namseoul University, 91 Daehak-ro, Sebuk-gu, Cheonan, Republic of Korea.
authors: Chang-Hee
authors: CH
authors: Lee
authors: Department of Emegency Medicine, College of Medicine, Chungbuk National University, 52 Naesudong-ro, Seowon-gu, Cheongju, Republic of Korea.
authors: Jung Soo
authors: JS
authors: Park
authors: Department of Emergency Medical Service. Howon University, 64 Howondae 3gil, Gunsan, Jeollabuk-do, Republic of Korea.
authors: Ji Yeon
authors: JY
authors: Jeong
authors: Department of Emergency Medical Service. Howon University, 64 Howondae 3gil, Gunsan, Jeollabuk-do, Republic of Korea.
authors: Sang Yeol
authors: SY
authors: Shin
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods; D035641:Chest Wall Oscillation / Q000379:methods*; D018592:Cross-Over Studies; D005240:Feasibility Studies; D006801:Humans; D008348:Manikins