Comparison of chest compression kinematics associated with over-the-head and standard cardiopulmonary resuscitation

Background: Over-the-head cardiopulmonary resuscitation (CPR) is a method of chest compression, which may be easier to perform than standard CPR in a confined space. Purpose: The purpose of this study was to evaluate the effects of over-the-head CPR on the kinematics and the force of delivered compressions. Methods: The subjects were 21 health care providers who were experienced in CPR. Each participant performed over-the-head CPR (O) and standard CPR (S). The compression-to-ventilation ratio was 30:2. The CPR duration was 2 minutes in each position, with a rest period of 15 minutes between each instance. The order in which positions were adopted was randomized. A manikin was equipped with a 6-axial force load cell to collect 3-dimensional compression forces at a sampling rate of 1000 Hz. An 8-camera digital motion analysis system was used to collect 3-dimensional trajectory information. Data were compared by crossover design analysis of variance (P < .05 represents statistical significance). Results: No significant differences in range of motion of the head, shoulder, lower trunk, hip, and knee were obtained using the 2 methods. The compression forces in O and S were 386.64 ± 47.32 and 397.35 ± 41.89 N, respectively (P > .05). No significant differences between the compression frequencies, depths, and percentages correct were obtained using the 2 methods. Conclusions: There were no differences between the kinematics, compression forces, depths, and frequencies obtained using the O and S CPR methods as practiced by experienced providers.