A randomised control trial comparing two techniques for locating chest compression hand position in adult Basic Life Support

Chest compressions performed correctly have the potential to increase survival post cardiac arrest. The 2005 European Resuscitation Council (ERC) guidelines altered and simplified instructions for hand position placement to increase the number of chest compressions performed. This randomised controlled trial compares chest compression efficacy (hand position and number of effective chest compressions) after training using the 2005 guidelines or the 2005 guidelines with a hand position modification based on 2000 ERC guidelines.

First year healthcare students at the University of Birmingham, United Kingdom, were randomly allocated to either '2005' or 'intervention' group immediately after passing a Basic Life Support (BLS) assessment to ERC standards. The 2005 group performed 2 min of BLS on a SkillReporter™ manikin (Laerdal Medical, Stavanger, Norway). The intervention group received training on hand placement using landmark techniques from the 2000 ERC guidelines; emphasising rapid hand positioning. This group also performed 2 min of BLS on a SkillReporter™ manikin.

82 students were assessed; 41 in the 2005 group and 41 in the intervention group. Average compression rate was 102 in the 2005 group and 104 in the intervention group (p=0.29). Average number of incorrect hand placements was 24 in the 2005 group and 9 in the intervention group (p=0.03).

The use of landmark measurement techniques in hand placement for external chest compressions does not have a detrimental effect on the number of chest compressions performed during BLS and increases correct hand positioning.