Mechanical loading of the low back during cardiopulmonary resuscitation

Aim: Back pain is often seen in professional rescuers after carrying out resuscitation. Back loading is known to be affected by the working surface height, but the relationship between the surface height and back loading during cardiopulmonary resuscitation (CPR) is poorly understood. The purpose of this study was to examine how back loading changes in response to CPR posture and surface height. Methods: Twenty-two experienced professional rescuers performed CPR using three surface heights; the floor (F), a table at a height of 63 cm (HT) and one at a height of 37 cm (LT). Results: The mean and maximal low back moment and compression force at HT were significantly smaller than those at LT and F. Conclusion: The results suggest that the HT task of chest compression produces the lowest low back moment and compression force. Thus, HT positioning may decrease the probability of low back pain and is suggested to be optimal height for inexperienced resuscitators, those with back injury, or those requiring a long operating duration.