Identification of rib cage's lower margin in cardiopulmonary resuscitation

The Guidelines of the American Heart Association (J Am Med Assoc 1992;268(16):2184-2198) and the European Resuscitation Council (Resuscitation 1992;24:103-110; Resuscitation 1998;37:67-80) for adult basic cardiopulmonary resuscitation (CPR), suggest that the hands of the rescuer should be positioned on the sternum of the victim after identification of the lower margin of the rib cage, but how this identification is made is not described. Lay persons have problems with the identification of anatomical structures that they cannot actually see (Bahr et al., Resuscitation 1997;35:23-6). Although this does not present a problem for those familiar with human anatomy, we have noticed that lay persons have problems with the identification of the lower margin of the rib cage. In this report, we suggest a method for correct and rapid recognition of the costal margin.