Compressing with dominant hand improves quality of manual chest compressions for rescuers who performed suboptimal CPR in manikins.
OBJECTIVE
The question of whether the placement of the dominant hand against the sternum could improve the quality of manual chest compressions remains controversial. In the present study, we evaluated the influence of dominant vs nondominant hand positioning on the quality of conventional cardiopulmonary resuscitation (CPR) during prolonged basic life support (BLS) by rescuers who performed optimal and suboptimal compressions.


METHODS
Six months after completing a standard BLS training course, 101 medical students were instructed to perform adult single-rescuer BLS for 8 minutes on a manikin with a randomized hand position. Twenty-four hours later, the students placed the opposite hand in contact with the sternum while performing CPR. Those with an average compression depth of less than 50 mm were considered suboptimal.


RESULTS
Participants who had performed suboptimal compressions were significantly shorter (170.2 ± 6.8 vs 174.0 ± 5.6 cm, P = .008) and lighter (58.9 ± 7.6 vs 66.9 ± 9.6 kg, P < .001) than those who performed optimal compressions. No significant differences in CPR quality were observed between dominant and nondominant hand placements for these who had an average compression depth of greater than 50 mm. However, both the compression depth (49.7 ± 4.2 vs 46.5 ± 4.1 mm, P = .003) and proportion of chest compressions with an appropriate depth (47.6% ± 27.8% vs 28.0% ± 23.4%, P = .006) were remarkably higher when compressing the chest with the dominant hand against the sternum for those who performed suboptimal CPR.


CONCLUSIONS
Chest compression quality significantly improved when the dominant hand was placed against the sternum for those who performed suboptimal compressions during conventional CPR.
Emergency Department, Southwest Hospital, Third Military Medical University, Chongqing 400038, China; Medical Training Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Juan
J
Wang
School of Biomedical Engineering, Third Military Medical University, Chongqing 400038, China.
Ce
C
Tang
Emergency Department, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Lei
L
Zhang
School of Biomedical Engineering, Third Military Medical University, Chongqing 400038, China.
Yushun
Y
Gong
Emergency Department, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Changlin
C
Yin
School of Biomedical Engineering, Third Military Medical University, Chongqing 400038, China. Electronic address: leeoken@gmail.com.
Yongqin
Y
Li
D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000379:methods / Q000592:standards; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006336:Heart Massage / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D008348:Manikins; D058996:Quality Improvement; D055815:Young Adult