title: Dominant hand position improves the quality of external chest compression: a manikin study based on 2010 CPR guidelines.
abstract: BACKGROUND
  The 2010 cardiopulmonary resuscitation (CPR) guidelines increased the importance of external chest compression. However, the best hand position to be the compressing one has not been identified.
  
  
  OBJECTIVE
  To investigate the effects of dominant or nondominant external chest compression hand position during CPR.
  
  
  METHODS
  Medical students performed five cycles of conventional CPR and completed one questionnaire. The CPR performances were manually evaluated, and detailed aspects of the external chest compression quality were assessed via the SimMan® Essential system (Laerdal China Ltd., Hangzhou, China).
  
  
  RESULTS
  One hundred fifty-seven students participated in the nondominant hand (NH) group, and 68 students participated in the dominant hand (DH) group. The manual evaluations revealed no differences between the two groups. The proportion of chest compressions "above 100 cpm [compressions per minute]" was higher in the DH group than in the NH group (97% vs. 92%, respectively, p = 0.002). The frequency distributions of the chest compression rates were also significantly different between the two groups (p < 0.0001). The distribution of the NH group was concentrated within "130-139" cpm, whereas this distribution was concentrated within "140-149" cpm in the DH group. The chest compression depth of the DH group was deeper than that of the NH group (p = 0.001). The depth of the fifth cycle was significantly decreased compared with those of cycles 1, 2, and 3 in the NH group. A greater number of full chest recoils were observed in the NH group (p = 0.02).
  
  
  CONCLUSIONS
  The dominant hand position during CPR was associated with a higher chest compression rate, a greater chest compression depth, and delayed fatigue.
authors: Medical College of Wuhan University, Wuchang, Wuhan, China; Emergency Center, Zhongnan Hospital of Wuhan University, Wuchang, Wuhan, China.
authors: Cheng
authors: C
authors: Jiang
authors: Medical College of Wuhan University, Wuchang, Wuhan, China.
authors: Shan
authors: S
authors: Jiang
authors: Emergency Center, Zhongnan Hospital of Wuhan University, Wuchang, Wuhan, China.
authors: Yan
authors: Y
authors: Zhao
authors: Medical College of Wuhan University, Wuchang, Wuhan, China.
authors: Bing
authors: B
authors: Xu
authors: Medical College of Wuhan University, Wuchang, Wuhan, China.
authors: Xian-long
authors: XL
authors: Zhou
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000379:methods* / Q000592:standards; D018592:Cross-Over Studies; D004503:Education, Medical, Graduate / Q000379:methods; D005221:Fatigue / Q000517:prevention & control; D005260:Female; D007839:Functional Laterality; D006225:Hand; D006801:Humans; D008297:Male; D008348:Manikins; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D055815:Young Adult
keywords: cardiopulmonary resuscitation (CPR); chest compression; dominant hand; fatigue; manikin