The most effective rescuer's position for cardiopulmonary resuscitation provided to patients on beds: a randomized, controlled, crossover mannequin study.

BACKGROUND: The effectiveness of chest compressions for cardiopulmonary resuscitation (CPR) is affected by the rescuer's position with respect to the patient. In hospitals, chest compressions are typically performed while standing beside the patient, who is placed on a bed.

STUDY OBJECTIVES: To compare the effectiveness of chest compressions, performed on a bed during 2 min of CPR, among three different rescuer positions: standing, on a footstool, or kneeling on the bed.

METHODS: We performed a crossover randomized simulation trial. Participants were recruited from among students in the Department of Paramedics from July to August 2011. Thirty-eight participants were enrolled, and they performed chest compressions on a mannequin for 2 min in each of the three different positions, with a 1-week interval between each position.

RESULTS: The number of adequate compressions (depth > 50 mm) and the mean compression depth were significantly greater in the kneeling and footstool positions than in the standing position, but there was no significant difference between the kneeling and footstool positions. There were no significant differences in the compression rate, the percentage of correctly released compressions, and the percentage of compressions performed using the correct hand position among the three rescuer positions.

CONCLUSION: The mean compression depth and the number of adequate compressions were greater for both the kneeling and footstool positions than for the standing position during 2 min of CPR. We recommend kneeling on a bed or standing on a footstool as the rescuer positions during hospital CPR on a bed.