Optimum Hand Position During Cardiopulmonary Resuscitation

Optimum Hand Position During Cardiopulmonary Resuscitation: Comparing Expiration and Inspiration View of the Scout Film of the Low Dose Chest Computed Tomography

The almost evidences of the optimal hand position during compression had been based on chest computed tomography (CT) or chest plain films of patients for investigating the effective location for compressing the left ventricle of the heart during cardiopulmonary resuscitation (CPR).

However every study was conducted at full inspired state of respiration. A prospective cohort study to evaluate the proper hand position during CPR based on expired respiratory state CT as the health screening would be needed.

Study Overview

• Status: Completed
• Conditions: Cardiopulmonary Resuscitation; Hand Position
• Intervention / Treatment: Radiation: low dose chest computed tomography

• Study Type: Interventional
• Enrollment (Actual): 127
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• over 18 years of age
• no history of heart or lung disease
• no history of chest or abdominal surgery

Exclusion Criteria:

• abnormal findings in LDCT, which might influence inspiration or expiration, were excluded after image interpretation by the board certified radiologists

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Other: Chest computed tomography; Low dose chest computed tomography during expiration and inspiration

Radiation: low dose chest computed tomography; All participants were evaluated 2 scout films during LDCT screenings. The first scout film was obtained while a participant was holding a comfortable expiration with the arms at down position, and the second scout film was obtained while a full inspiration with the arms at raised position. The axial images of LDCT were taken during participants' full inspiration. The radio-opaque marker was attached to the participants' skin where the lowest part of sternum was palpable, because the sternum moves according to the position of arms and respiration.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
proper hand position during CPR using the scout film of low dose chest computed tomography	proper hand position during CPR based on comparison between expiration with the arms at down position and inspiration the arms at raised position. Measurement will be assessed with a length of xiphoid process to arbitrary center of heart	five months

Secondary Outcome Measures

Outcome Measure	Time Frame
predicted compressed organs in CPR using the scout film of low dose chest computed tomography Measurement will be assessed with scout film silhouette of organs under quarterly divided sternum.	five months

Collaborators and Investigators

• Sponsor: Seoul National University Bundang Hospital

Publications and helpful links

General Publications

• Perkins GD, Handley AJ, Koster RW, Castren M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Grasner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99. doi: 10.1016/j.resuscitation.2015.07.015. Epub 2015 Oct 15. No abstract available.
• Klouche K, Weil MH, Sun S, Tang W, Povoas H, Bisera J. Stroke volumes generated by precordial compression during cardiac resuscitation. Crit Care Med. 2002 Dec;30(12):2626-31. doi: 10.1097/00003246-200212000-00002.
• Travers AH, Perkins GD, Berg RA, Castren M, Considine J, Escalante R, Gazmuri RJ, Koster RW, Lim SH, Nation KJ, Olasveengen TM, Sakamoto T, Sayre MR, Sierra A, Smyth MA, Stanton D, Vaillancourt C; Basic Life Support Chapter Collaborators. Part 3: Adult Basic Life Support and Automated External Defibrillation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2015 Oct 20;132(16 Suppl 1):S51-83. doi: 10.1161/CIR.0000000000000272.
• Cha KC, Kim HJ, Shin HJ, Kim H, Lee KH, Hwang SO. Hemodynamic effect of external chest compressions at the lower end of the sternum in cardiac arrest patients. J Emerg Med. 2013 Mar;44(3):691-7. doi: 10.1016/j.jemermed.2012.09.026. Epub 2012 Dec 4.
• Qvigstad E, Kramer-Johansen J, Tomte O, Skalhegg T, Sorensen O, Sunde K, Olasveengen TM. Clinical pilot study of different hand positions during manual chest compressions monitored with capnography. Resuscitation. 2013 Sep;84(9):1203-7. doi: 10.1016/j.resuscitation.2013.03.010. Epub 2013 Mar 15.
• Orlowski JP. Optimum position for external cardiac compression in infants and young children. Ann Emerg Med. 1986 Jun;15(6):667-73. doi: 10.1016/s0196-0644(86)80423-1.
• Pickard A, Darby M, Soar J. Radiological assessment of the adult chest: implications for chest compressions. Resuscitation. 2006 Dec;71(3):387-90. doi: 10.1016/j.resuscitation.2006.04.012. Epub 2006 Sep 18.

Study record dates

Study Major Dates

• Study Start: August 1, 2015
• Primary Completion (Actual): December 1, 2015
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: March 14, 2016
• First Submitted That Met QC Criteria: March 16, 2016
• First Posted (Estimate): March 22, 2016

Study Record Updates

• Last Update Posted (Actual): April 18, 2018
• Last Update Submitted That Met QC Criteria: April 16, 2018
• Last Verified: April 1, 2018

More Information

Terms related to this study

• Other Study ID Numbers: Hear_position_01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO