The suprasternal notch as a landmark of chest compression depth in CPR

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.

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.

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.

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.