Effects of vertical compression during pediatric cardiopulmonary resuscitation using the one-handed chest compression technique

The posture of the rescuer while performing the one-handed chest compression (OHCC) has not yet been evaluated. This study aimed to investigate the effect of vertical compression during pediatric cardiopulmonary resuscitation (CPR) using the OHCC technique. This was a prospective randomized crossover simulation trial. A total of 42 medical doctors conducted a 2-min single-rescuer CPR using the conventional OHCC (Test 1) or vertical OHCC (Test 2) technique on a pediatric manikin. The chest compression and ventilation parameters were measured in real time during the experiments using sensors embedded in the manikin. In addition, the compression force of each technique was measured using a force plate. The average and adequate chest compression depth (CCD) were significantly higher in Test 2 than in Test 1 (average depth: 54.0 mm (interquartile range [IQR]: 48.5–56.0) in Test 2 vs. 49.0 mm (IQR: 40.0–54.0) in Test 1, P < 0.001; adequate depth: 99.0% (IQR: 36.3–100.0) in Test 2 vs. 52.0% (IQR: 0.0–98.0) in Test 1, P < 0.001). The average force of compression was also significantly higher in vertical OHCC than that in conventional OHCC (25.7 kg ± 4.4 in vertical OHCC vs. 24.5 kg ± 4.2 in conventional OHCC, P < 0.001). The ventilation parameters were not significantly different between Tests 1 and 2. The vertical OHCC could provide a deeper and more adequate CCD compared with the conventional OHCC, and the advantages of the vertical OHCC originate from the superiority of the compression force.