The Effect of Using a Step Stool on Chest Compressions Quality During Cardiopulmonary Resuscitation: A Systemic...

Area of Science:

• Emergency Medicine
• Cardiology
• Resuscitation Science

Background:

• Effective cardiopulmonary resuscitation (CPR) relies on high-quality chest compressions (CCs).
• The potential benefit of using a step stool to enhance CC quality during CPR is not well-established.

Purpose of the Study:

• To systematically review and analyze the impact of a rescuer using a step stool on chest compression quality during CPR.

Main Methods:

• A systematic review was conducted across five major databases.
• Data extraction, risk of bias, and GRADE assessments were performed independently by two authors.
• Random effects modeling was employed for data analysis, with risk of bias assessed using Cochrane tools.

Main Results:

• Six studies (four adult, two pediatric) were included, most with a serious risk of bias.
• Step stool use showed a slight increase in CC depth (MD 2.74 mm, low certainty) and rate (MD 2.97/min, low certainty) in adults and overall.
• Effects on pediatric CC rate, chest recoil, and rescuer-manikin angle were uncertain or based on very low-certainty evidence.

Conclusions:

• Low-certainty evidence suggests step stool use may marginally improve CC depth and rate in simulated CPR settings.
• Clinical significance remains unclear, and effects on chest recoil, rescuer angle, and other parameters are highly uncertain.
• Further high-quality research is needed to clarify the role of step stools in CPR.