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. 2020 Apr;17(2):e12314.
doi: 10.1111/jjns.12314. Epub 2020 Jan 19.

Effect of chest compression with kneeling on the bed in clinical situations

Tomoyuki Hasegawa  1 , Ritsu Okane  1 , Yoko Ichikawa  1 , Sayuri Inukai  1 , Shin Saito  1
Affiliations

Effect of chest compression with kneeling on the bed in clinical situations

Tomoyuki Hasegawa et al. Jpn J Nurs Sci. 2020 Apr.

Abstract

Aim: Cardiopulmonary resuscitation is vital for survival after cardiac arrest, and chest compressions are an important aspect of this. When performing chest compression in a hospital setting, the rescuer often has to kneel on the bed to overcome inconvenient differences in height between the rescuer and the bed. However, as yet no study has evaluated the quality of chest compressions in this position. The aim of this study was to examine the impact on the quality of chest compressions while kneeling on the bed.

Methods: Fifteen female students performed 2-min chest compressions on a manikin placed on the floor and a bed. Measurement parameters included compression depth, heart rate, integrated electromyogram, and a visual analog scale. The parameters were measured every 30 s and were statistically compared between the conditions.

Results: Compression depth at 30, 60, 90, and 120 s differed significantly between the conditions. Heart rate values at 150 and 210 s of recovery significantly differed between the conditions. Integrated electromyogram values for the trapezius, rectus femoris, and biceps femoris differed between the floor and bed conditions during 2-min chest compressions, whereas the external oblique muscle significantly differed at 60 and 120 s. Visual analog scales for fatigue, effectiveness, and stability significantly differed between the conditions.

Conclusion: Kneeling on the bed does not enable grounding of the toe, causing the upper body to be unstable and limiting generation of the power required for chest compression. Our results suggest that rotation every minute is necessary to maintain effective cardiopulmonary resuscitation while kneeling on the bed.

Keywords: cardiopulmonary resuscitation; chest compression; fatigue; grounding toe; rescuer's position.

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Conflict of interest statement

There are no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Experimental protocol
Figure 2
Figure 2
Positions for the chest compressions on the floor (left) and bed (right)
Figure 3
Figure 3
Comparison of compression depth between the floor and bed conditions. Values are shown as medians and ranges using a boxplot. Significant differences were observed between the conditions (*p < .05 and **p < .01; Wilcoxon signed rank test).; n = 15
Figure 4
Figure 4
Comparison of heart rate between the floor and bed conditions. Values are shown as medians and ranges using a boxplot. Significant differences were observed (*p < .05 and **p < .01; Wilcoxon signed rank test). HR, heart rate. The chest compression phase was between rest and 120 s, and the recovery phase was between 120 and 240 s.; n = 15
Figure 5
Figure 5
Electromyogram characteristics of one participant during the final 10 s of chest compressions in the floor condition. CD: compression depth. The dashed line shows the moment of chest compression
Figure 6
Figure 6
Electromyogram characteristics of one participant during the final 10 s of chest compressions in the bed condition. CD: compression depth. The dashed line shows the moment of chest compression
Figure 7
Figure 7
Comparison of visual analog scale values between the floor and bed conditions. Values are shown as medians and ranges using a boxplot. Significant differences were observed (*p < .05 and **p < .01; Wilcoxon signed rank test). VAS: visual analog scale. Each bar represents the participants' subjective assessment of their fatigue, effectiveness, and sense of stability, and of the load in their shoulders, arms, back, belly, waist, thighs, and calves.; n = 15
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