References
Chest compression efficacy of child resuscitators
Abstract
Background:
Chest compression efficacy determines blood flow in cardiopulmonary resuscitation (CPR) and relies on body mechanics, so resuscitator weight matters. Individuals of insufficient weight are incapable of generating a sufficient downward chest compression force using traditional methods.
Aims:
This study investigated how a resuscitator's weight affects chest compression efficacy, determined the minimum weight required to perform chest compressions and, for children and adults below this minimum weight, examine alternate means to perform chest compressions.
Methods:
Volunteers aged 8 years and above were enrolled to perform video-recorded, music-facilitated, compression-only CPR on an audible click-confirming manikin for 2 minutes, following brief training. Subjects who failed this proceeded to alternate modalities: chest compressions by jumping on the lower sternum; and squat-bouncing (bouncing the buttocks on the chest). These methods were assessed via video review.
Findings:
There were 57 subjects. The 30 subjects above 40kg were all able to complete nearly 200 compressions in 2 minutes. Success rates declined in those who weighed less than 40kg. Below 30 kg, only one subject (29.9 kg weight) out of 14 could achieve 200 effective compressions. Nearly all of the 23 subjects who could not perform conventional chest compressions were able to achieve effective chest compressions using alternate methods.
Conclusion:
A weight below 40kg resulted in a declining ability to perform standard chest compressions effectively. For small resuscitators, the jumping and squat-bouncing methods resulted in sufficient compressions most of the time; however, chest recoil and injuries are concerns.
Out-of-hospital cardiac arrest survival is improved by bystander cardiopulmonary resuscitation (CPR) as a bridge to the arrival of trained resuscitators (usually from emergency medical services; EMS). Chi et al (2010) concluded that chest compressions to the standard 2-inch (5.1 cm) depth required about 500 Newtons of force (112 pounds of force or 51 kg of mass on Earth). This suggests that the minimum weight of a resuscitator, EMS or otherwise, must be around 51 kg. Other studies have reported a significant difference in the quality of chest compressions between light and heavy rescuers CPR (Hasegawa et al, 2014; Contri et al, 2017). Heavier rescuers can perform and sustain high-quality chest compressions because they can use their body weight to provide chest compressions without becoming rapidly exhausted, making the weight of the rescuer critical to effective chest compressions (Hasegawa et al, 2014).
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