Influence of rescuer position and arm angle on chest compression quality: An international multicentric randomized crossover simulation trial

Abstract

Background: Success in resuscitation depends not only on the timeliness of the maneuvers but also on the quality of chest compressions. Factors such as the rescuer position and arm angle can significantly impact compression quality. Aim: This study explores the influence of rescuer positioning and arm angle on the quality of chest compressions among healthcare professionals experienced in cardiopulmonary resuscitation. Methods: In this international, multicentric, randomized crossover simulation trial with independent groups, healthcare professionals were assigned to one of four positions: kneeling on the floor, standing, standing on a step stool, and kneeling on the bed. Participants performed two 3-minute trials of uninterrupted chest compressions at arm angles of 90° and 105°. Compression quality was assessed, using manikin derived data. Results: A total of 76 participants entered the study. Those using a 90° arm angle exhibited higher compression scores than those at a 105° angle. Rescuers standing on a step stool maintained higher scores over time when compared to other groups. In contrast, rescuers kneeling on the bed consistently scored below 75% throughout the trial, with particularly low scores at the 105° angle. Conclusion: Rescuer position and arm angle significantly influence CPR quality, with a 90° arm angle and elevated positioning optimizing compression depth and effectiveness. The results recommend against kneeling on the bed due to its negative impact on chest compression quality.

Keywords

• Cardiopulmonary resuscitation
• Chest compressions quality
• Rescuer position
• Arm angle
• Physical activity
• CPR