title: The suprasternal notch as a landmark of chest compression depth in CPR.
abstract: OBJECTIVE
  This study was performed to determine a landmark for chest compression depth for adult cardiopulmonary resuscitation (CPR) using chest computed tomography and to evaluate the validity of the landmark.
  
  
  METHODS
  The external anteroposterior diameters (EAPDs) of each chest at the suprasternal notch (SN) and the lower half (LH) of the sternum were measured. We analyzed the differences in the EAPDs between the LH and the SN in each EAPD group in the LH of the sternum as follows: less than 20.00, 20.00 to 21.99, 22.00 to 23.99, greater than or equal to 24.00. We compared the differences in the EAPDs between the 2 points with 50 mm and the chest compression depth on simulated one-fourth external chest compressions for each EAPD group on the LH of the sternum.
  
  
  RESULTS
  The mean difference in the EAPDs between the SN and the LH was 5.16 ± 0.91 mm. The differences in the EAPDs between the SN and the LH of the sternum with 50 mm did not indicate a significant difference. The mean one-fourth EAPD at the LH of the sternum was 5.50 ± 0.53 mm. There was not a significant difference in the residual chest depth on one-fourth simulated chest compression for each EAPD group on the LH of the sternum.
  
  
  CONCLUSIONS
  The SN may have value as a functional landmark for chest compression depth in adult CPR. Our findings combined with the simulated one-fourth chest compressions were more consistent with the depth between 50 and 60 mm recommended by the 2015 CPR guidelines.
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
authors.forename: Tae Hu
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea. Electronic address: ssoon0702@naver.com.
authors.forename: Soo Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
authors.forename: Ryun Kyung
authors.initials: RK
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
authors.forename: Changwoo
authors.initials: C
authors.lastname: Kang
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Jeong
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
authors.forename: Seong Chun
authors.initials: SC
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea.
authors.forename: Sang Bong
authors.initials: SB
authors.lastname: Lee
mesh_terms: D000328:Adult; D059925:Anatomic Landmarks / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D000886:Anthropometry; D005260:Female; D006336:Heart Massage / Q000592:standards*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D013249:Sternum / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed