Lay rescuer CPR: Exposing the Chest Facilitates more Accurate and Safer Chest Compression

ABSTRACT

PURPOSE: "Chest compression-only" CPR encourages CPR by untrained lay people. Guidelines do not include victim's chest exposure, which might result in inaccurate compression point; therefore, this study compares accuracy of lay rescuer's chest compression point in dressed and undressed situations. METHODS: In this prospective observational cross-over study conducted in a simulation center of a tertiary academic hospital in the Republic of Korea, 96 non-medical college student volunteers were asked to point in random order to the location of four reference chest compression points [inter-nipple line (INL), center of the chest (CoC), lower quarter of the sternum (LQS), and lower end of the sternum (LES)]. In dressed and undressed situations, length from sternal notch to each of the subject-recognized compression and reference points and degree of deviation from sternum midline was compared. RESULTS: In both dressed and undressed situations, INL was closest while LQS, CoC, and LES were further away, in said order, from the sternal notch. The undressed situation showed association with lower reference and subjectrecognized chest compression point differences; subjectrecognized chest compression point deviation; and out-ofchest compression point frequency. CONCLUSION: Addition of "exposing victim's chest" to the CPR education program for untrained lay people might facilitate accurate and safe localization of chest compression points in cardiac arrest patients.