Quality of chest compressions performed by inexperienced rescuers in simulated cardiac arrest associated with pregnancy

Abstract

OBJECTIVE: We aimed to compare the quality of chest compressions performed by inexperienced rescuers in different positions, notably supine and at a 30° inclined lateral position, to ascertain whether high-quality chest compression is feasible on a pregnant subject in cardiac arrest. SUBJECTS AND METHODS: We performed a prospective, randomised crossover design study. Each participant performed 2-min chest compressions in two different positions on a mannequin: a supine position and a 30° left inclined lateral position. After 2 min of chest compression in one position, the participant took a rest for 10 min to minimise rescuer fatigue and then performed chest compression in the second position. Data on chest compression rate, mean chest compression depth, correct compression depth rate, correct recoil rate, and correct hand position rate were collected. To measure the angle between the rescuer's arm and the victim's chest surface, chest compressions were recorded with a video recorder. After each practice session, participants were asked to report the subjective difficulty of performing chest compressions using a visual analogue scale. RESULTS: All 32 participants successfully completed the study. The mean compression rate and depth were 121.0 per minute and 53.3 mm in the supine position and 118.8 per minute and 52.0 mm in the inclined lateral position, respectively (p=0.978 and p=0.260, respectively). Also, there were no differences in the correct compression depth rate, the correct hand position rate, or the correct recoil rate (p=0.426, p=0.467, and p=0.260, respectively). However, the lowest and highest angles and the subjective difficulty of chest compression differed significantly (p<0.001, p<0.001, and p=0.007, respectively). CONCLUSIONS: Inexperienced rescuers appear to be capable of performing high-quality chest compressions in a 30° inclined lateral position on pregnant women in a simulated cardiac arrest state.