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

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).