The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

Importance of dominant hand position during external cardiac compression.

Thomas A. Barnes, EdD, RRT, FAARC, Christine R Duclos, Michael K Le, Doris C Obando, Craig D Smallwood, Megan C Vaccaro, Aizi Zhuang Department of Cardiopulmonary and Exercise Sciences, School of Health Professions, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts

Background: This study on a manikin was designed to evaluate whether the position of the rescuer's dominant hand (DH) in relation to the non dominant hand (ND) has any influence on the effectiveness of external cardiac compression (ECC). Our null hypothesis was that using your DH on the chest will produce the same quality ECC as would use of your ND.

Methods: We gathered data on a prospective convenience sample of 13 Basic Life Support certified cardiopulmonary science students using a crossover design. Subjects were asked to perform ECC for 3 min according to American Heart Association (AHA) 2000 Guidelines on a Laerdal PC ResusciAnne Skill Reporting System. The placement of the DH or ND on the chest was randomly assigned and three trials were conducted. The subject was asked to return one week later for three more trials using their other hand on the chest. A metronome beep was provided by the manikin as a guide to maintain a compression rate of ECC of 100 min-1. A verbally prompted seven second pause in ECC was taken after 15 compressions to simulate deliver of two ventilations. Variables recorded during ECC performance were average rate, count per minute, average depth, adequate depth, insufficient depth, excessive depth, average duty cycle ratio, average down-stroke/up-stroke ratio, ECC with correct hand position, and incomplete relaxation of the chest. Data were analyzed using a nonparametric Mann-Whitney Test. Alpha was set at 0.05.

Results:
There was no significant difference in effectiveness of ECC for all variables measured when DH was compared to ND (P> 0.05 in each case).

Variable Dominant Hand Non Dominant Hand
Average rate min-1 99.6 ± 6.8 99.5 ± 6.4
Average count min-1 58.4 ± 2.3 58.3 ± 2.5
Average depth 45.8 ± 5.2 45.1 ± 6.3
Insufficient depth (number in 3 min) 16.9± 25.9 24.0 ± 49.7
Excessive depth (number in 3 min) 37.4 ± 53.5 30.7 ± 53.4
Average duty cycle 0.32 ± 0.04 0.33 ± 0.05
Average down-stroke/upstroke-stroke ratio 0.60 ± 0.11 0.62 ± 0.13
Incomplete relaxation (number in 3 min) 0 0
Correct hand position (% of total) 98.1 ± 4.5 89.1 ± 21.9

Conclusion: Based on these findings use of either right or left hand on the chest will provide similarly effective ECC. Metronome beep guidance allows AHA recommended ECC compression rate to be maintained. These data should be subjected to a clinical study.

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