Center of the Chest Versus Inter-nipple Line in the Selection of a Chest Compression Site by Novice Rescuers

ABSTRACT

PURPOSE: The aim of this study was to compare the distribution and risk from hand positions applied at the center of the chest (CoC) versus the inter-nipple line (INL) during external chest compression by novice rescuers. METHODS: This simulation study included 105 participants. The participants were given photographs of the unexposed male chest and asked to mark a cross at the center of the chest and at the midpoint of the inter-nipple line. The range of contact with the chest was estimated by measuring the participants' palm width. The median and distribution of the two points were then compared and analyzed to determine whether the range in contact with the chest involved the xiphoid process. RESULTS: The level of the INL was approximately 0.8 cm higher at the sternum than the CoC (p<0.001), while the standard deviation of the CoC [1.8(0.6-3.8)] was higher than that of the INL [1.2(0.4-2.4)] (p<0.001). There were more cases in which the palm range involved the xiphoid process in the CoC group [15(14.3%)] than the INL group [1(0.9%)] (p<0.001). CONCLUSION: For male adult patients, chest compression at the level of the INL by novice rescuers is safer and more intensive than compression at the level of the CoC.