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Chest compression using the foot or hand method: a prospective, randomized, controlled manikin study with school

Habib Kherbeche1, Nicole Exer, Wolfram Schuhwerk

  • 1aPrivate Practice, Gossau SG bCentral Emergency Department cREA 2000 CRNA, CNE, REA 2000, Centre for Resuscitation and Simulation Training, Cantonal Hospital St Gallen, St Gallen dDepartment of Anaesthesiology, University Hospital Basel, Basel, Switzerland.

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
|October 21, 2015
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Summary

The foot method (FM) did not improve chest compression depth accuracy compared to the hand method (HM) in school children. The hand method (HM) showed better frequency and complete decompression during resuscitation training.

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Area of Science:

  • Pediatric Resuscitation
  • Cardiopulmonary Resuscitation Techniques
  • Emergency Medicine Education

Background:

  • Maintaining adequate chest compression depth is crucial but challenging in resuscitation.
  • Previous studies suggested the foot method (FM) might be advantageous for lighter individuals.
  • Resuscitation guidelines increasingly emphasize chest compression quality, necessitating evaluation of different techniques.

Purpose of the Study:

  • To compare the effectiveness of the foot method (FM) versus the hand method (HM) for chest compressions in school children.
  • To determine if school children achieve better compression depth quality using the FM compared to the HM.
  • To assess the impact of body weight on the efficacy of each method.

Main Methods:

  • 105 school children (aged 12-15) were randomized to either the foot method (FM) or hand method (HM) group.
  • Participants underwent a brief training video and practice session before performing a 2-minute chest compression sequence.
  • Compression quality, including depth, frequency, and decompression, was recorded and analyzed.

Main Results:

  • Both groups demonstrated low mean percentages of correct chest compression depth (FM 47%, HM 45%).
  • The hand method (HM) group exhibited significantly better compression frequency (98% vs. 86%) and complete decompression (99% vs. 91%) compared to the foot method (FM) group.
  • No significant difference in compression depth accuracy was observed between the FM and HM groups, regardless of participant body weight.

Conclusions:

  • The foot method (FM) does not offer an advantage over the hand method (HM) in achieving accurate chest compression depth for children and adolescents.
  • The hand method (HM) proved superior in terms of compression frequency and complete chest recoil.
  • Current evidence does not support the widespread adoption of the foot method (FM) for pediatric resuscitation training over the traditional hand method (HM).