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ID 28884
file
creator
Yuge, Osafumi
subject
Cardiopulmonary resuscitation (CPR)
Chest compression
Hand position
Anatomical landmark
Inter-nipple line; Complication
Visceral injury
NDC
Medical sciences
abstract
Background: No previous study has investigated the safety of hand position during chest compression determined by the inter-nipple line, in which the heel of one hand is positioned on the centre of the chest between the nipples, from the standpoint of prevention of organ injury. Methods: We measured the distance from the xiphisternal junction to the inter-nipple line (dN) in 1000 surgical patients and the heel length (H) of hands in 100 healthy Volunteers, then used the formula H/2 - dN to determine the amount of deviation when the heel of the rescuer's hand extended to the xiphoid process (D). Next, 100 surgical patients were randomly assigned to 18 anaesthesiologists, who placed the heels of their hands on the sternum for validation. Results: The D value was positive in 551 patients, indicating that the heel may extend to the xiphoid process during chest compression in those individuals. Multivariate logistic-regress ion analyses showed that deviations beyond the xiphoid process to the epigastric region were more likely to occur in female (OR 3.52), elderly (OR 2.00), and short-statured (OR 2.09) patients, and with male rescuers (OR 2.81). During actual positioning, deviation occurred in 51 patients and extended to the epigastric region in 5 females. Conclusions: Simulation of hand position determined by the inter-nipple line resulted in placement of the rescuer's hands over the xiphoid process in nearly half of the patients. Hand deviation to the epigastric region may Occur when the patient is a short-statured or elderly female, and when the rescuer is male.
journal title
Resuscitation
volume
Volume 80
issue
Issue 10
start page
1175
end page
1180
date of issued
2009-10
publisher
Elsevier Ireland Ltd
issn
0300-9572
ncid
publisher doi
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
author
rights
Copyright (c) 2009 Elsevier Ireland Ltd
relation url
department
Graduate School of Biosphere Science