Up-down hand position switch may delay the fatigue of non-dominant hand position rescuers and improve chest compression quality during cardiopulmonary resuscitation: a randomized crossover manikin study.

Previous studies have shown improved external chest compression (ECC) quality and delayed rescuer fatigue when the dominant hand (DH) was in contact with the sternum. However, many rescuers prefer placing the non-dominant hand (NH) in contact with the sternum during ECC. We aimed to investigate the effects of up-down hand position switch on the quality of ECC and the fatigue of rescuers during cardiopulmonary resuscitation (CPR). After completion of a review of the standard adult basic life support (BLS) course, every candidate performed 10 cycles of single adult CPR twice on an adult manikin with either a constant hand position (CH) or a switched hand position (SH) in random order at 7-day intervals. The rescuers' general characteristics, hand positions, physiological signs, fatigue appearance and ECC qualities were recorded. Our results showed no significant differences in chest compression quality for the DH position rescuers between the CH and SH sessions (p>0.05, resp.). And also no significant differences were found for Borg score (p = 0.437) or cycle number (p = 0.127) of fatigue appearance after chest compressions between the two sessions. However, for NH position rescuers, the appearance of fatigue was delayed (p = 0.046), with a lower Borg score in the SH session (12.67 ± 2.03) compared to the CH session (13.33 ± 1.95) (p = 0.011). Moreover, the compression depth was significantly greater in the SH session (39.3 ± 7.2 mm) compared to the CH session (36.3 ± 8.1 mm) (p = 0.015). Our data suggest that the up-down hand position switch during CPR may delay the fatigue of non-dominant hand position rescuers and improve the quality of chest compressions.

Awareness and attitudes of Chinese students towards cardiopulmonary resuscitation.

BACKGROUND: A large number of sudden cardiac arrests occur annually, but the worldwide survival rate is less than 1%. Early initiation of bystander Cardiopulmonary resuscitation (CPR) would improve the survival rate of out-of-hospital sudden cardiac arrests. Students play an important role as bystanders on and off campus both now and in the future. So we wanted to investigate the awareness and attitudes towards CPR of Chinese students, in order to improve the dissemination of bystander CPR in China. METHODS: The survey was conducted by questionnaire in November 2007. We had chosen 3500 students from the city of Wuhan in China randomly according to the stratified cluster sampling technique. RESULTS: There were 3248 questionnaires answered, and 2763 questionnaires were considered valid. Few respondents reported that they had heard (28%) and studied (27%) of CPR, and only 3% of the respondents had attended a CPR course. The two major sources of information about CPR for Chinese students were television and books. Most respondents expressed a desire to learn CPR (77%), and were willing to disseminate CPR (73%). CONCLUSION: Dissemination of CPR among Chinese students has not been executed satisfactorily. The finding highlights the importance of CPR dissemination and efforts should be made to provide more convenient, effective and attractive ways for the Chinese public, especially students, to learn CPR.