Cardiac Arrest (CA)
Conditions
Keywords
cardiac arrest, cardiopulmonary resuscitation, chest compression, hand position
Brief summary
This randomized crossover simulation study will compare two hand positions used during chest compressions: interlocked fingers and non-interlocked hands placed one on top of the other. The study will evaluate whether the non-interlocked hand position is non-inferior to the interlocked-finger technique with regard to chest compression depth, and will compare the two techniques in terms of CPR quality, rescuer comfort, fatigue, pain or discomfort, and perceived hand-position stability.
Detailed description
High-quality chest compressions are a key component of cardiopulmonary resuscitation (CPR). Current international resuscitation guidelines recommend placing one hand on top of the other during chest compressions, but recommendations regarding whether the fingers should be interlocked or simply placed on top of each other are based on limited scientific evidence. This prospective, randomized, controlled crossover simulation study will compare two hand positions during continuous chest compressions on an adult CPR manikin. Each participant will perform two 2-minute chest compression periods, using both techniques in a computer-randomized order: (1) interlocked fingers, representing the commonly taught technique, and (2) non-interlocked hands placed one on top of the other. A 10-minute seated rest period will separate the two measurement periods. The primary outcome will be mean chest compression depth. Secondary outcomes will include compression rate, proportion of compressions with adequate depth and full chest recoil, temporal changes in compression depth, and subjective assessments of pain, discomfort, physical fatigue, hand-position stability, and confidence in performing chest compressions. Participants will also indicate which technique they would prefer in a real resuscitation situation. The study will be conducted in a simulation environment at the Human Patient Simulation Center of the University of Pécs Faculty of Health Sciences. Participants will not receive real-time feedback from the manikin during the measurements.
Interventions
BEHAVIORALInterlocked-finger chest compression technique
Participants will perform chest compressions using the interlocked-finger hand position. One hand will be placed on the lower half of the sternum and the other hand on top, with the fingers interlocked. The intervention will consist of 2 minutes of continuous chest compressions performed at a target rate of 100-120 compressions per minute and a target depth of 5-6 cm, with complete chest recoil after each compression. No real-time feedback will be provided.
BEHAVIORALOverlapped hands chest compression technique
Participants will perform chest compressions using the non-interlocked hand position. One hand will be placed on the lower half of the sternum and the other hand on top without interlocking the fingers. The intervention will consist of 2 minutes of continuous chest compressions performed under the same conditions as the interlocked-finger technique, with a target rate of 100-120 compressions per minute, a target depth of 5-6 cm, and complete chest recoil after each compression. No real-time feedback will be provided.
Sponsors
University of Pecs
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Masking description
The primary outcome data will be analyzed using coded intervention labels, with the allocation key withheld from the data analyst until the prespecified primary analysis has been completed.
Intervention model description
Participants will be randomized to one of two treatment sequences. In Sequence A, participants will perform chest compressions using the interlocked-finger hand position followed by the non-interlocked hand position. In Sequence B, the order will be reversed. Each intervention period will last 2 minutes and will be separated by a 10-minute seated rest period.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Adults aged 18 years or older * Healthcare professionals or laypersons * Physically able to perform chest compressions * Able and willing to provide written informed consent to participate in the study
Exclusion criteria
* Acute injury of the upper extremities * Chronic musculoskeletal disease or symptoms that may interfere with the ability to perform chest compressions with adequate quality * technical issue during data collection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean chest compression depth (mm) | During procedure. | Mean chest compression depth recorded continuously by the manikin's integrated measurement system during CPR performance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Chest compression rate (per minute) | During procedure. | Mean chest compression rate (compressions per minute) recorded by the manikin's integrated measurement system during CPR performance. |
| Proportion of compressions with adequate depth (%) | During procedure. | Proportion of chest compressions meeting the predefined target depth, as recorded by the manikin's integrated measurement system. |
| Proportion of compressions with complete chest recoil (%) | During procedure. | Proportion of chest compressions followed by complete chest recoil, as recorded by the manikin's integrated measurement system. |
| Interruption duration (sec) | During procedure. | Duration of interruptions in chest compressions (hand-off time), if applicable, recorded by the manikin's integrated measurement system. |
| Overall chest compression quality score (points, mean, SD) | During procedure. | Overall chest compression quality score calculated by the manikin's integrated measurement system based on predefined CPR performance parameters. |
| Self-reported hand pain | Immediately after the CPR procedure (within 15 minutes) | Participants' self-reported overall hand pain following CPR performance, assessed using a 0-10 Numeric Rating Scale, where 0 indicates no pain and 10 indicates the worst imaginable pain. |
| Finger discomfort | Immediately after the CPR procedure (within 15 minutes) | Participants' self-reported discomfort in the fingers following CPR performance, assessed using a 0-10 Numeric Rating Scale. |
| Wrist discomfort | Immediately after the CPR procedure (within 15 minutes) | Participants' self-reported wrist discomfort following CPR performance, assessed using a 0-10 Numeric Rating Scale. |
| Perceived physical fatigue | Immediately after the CPR procedure (within 15 minutes) | Participants' self-reported physical fatigue following CPR performance, assessed using a 0-10 Numeric Rating Scale. |
| Perceived hand-position stability | Immediately after the CPR procedure (within 15 minutes) | Participants' perceived stability of their hand position during CPR performance, assessed using a 0-10 Numeric Rating Scale. |
| Perceived hand slippage | Immediately after the CPR procedure (within 15 minutes) | Participants' perceived sensation of hand slippage during CPR performance, assessed using a 0-10 Numeric Rating Scale. |
| Preferred hand position | Immediately after the CPR procedure (within 15 minutes) | Participants' preferred hand position for performing CPR in a real-life cardiac arrest situation. |
Countries
Hungary
Contacts
CONTACTBálint Bánfai, PhD
PRINCIPAL_INVESTIGATORBálint Bánfai, PhD
University of Pécs Faculty of Health Sciences
Outcome results
None listed