In this blog we are going to focus on adult compressions done in the kneeling position. We will look at compressions done in the standing position, for those who are in healthcare setting, in a later blog.
Research continues to point to an increase in survivabilitywhen compressions are started quickly. In addition, it is important to know how to perform compressions properly to give a person their best chance of survival. You have heard “anything is better than nothing” and this is true…..but lets look at what to do to INCREASE SURVIVABILITY.
I feel often times, in training, there is a lack of focus on proper body mechanics or body positioning to optimize quality. You hear press deeper…..slow down….speed up, etc. But what does it actually look like to do compressions to the best of your ability??? Hands down…..proper body positioning when performing CPR enhances quality of compressions and increases survivability.
Not all situations are created equally. Whatever situation you find your self in always do the best you can!
𝐏𝐫𝐨𝐩𝐞𝐫 𝐛𝐨𝐝𝐲 𝐩𝐨𝐬𝐢𝐭𝐢𝐨𝐧𝐢𝐧𝐠 when performing CPR 𝐞𝐧𝐡𝐚𝐧𝐜𝐞𝐬 𝐪𝐮𝐚𝐥𝐢𝐭𝐲 𝐨𝐟 𝐜𝐨𝐦𝐩𝐫𝐞𝐬𝐬𝐢𝐨𝐧𝐬 and 𝐢𝐧𝐜𝐫𝐞𝐚𝐬𝐞𝐬 𝐬𝐮𝐫𝐯𝐢𝐯𝐚𝐛𝐢𝐥𝐢𝐭𝐲.
Ideal ADULT compressions are:
Depth greater than 2 inches
Full chest recoil
Rate of 100-120 compressions per minute
Minimizing pauses, and when a pause is necessary restart compressions less than 5-10 seconds
Things we look for when adult compressions are done in the kneeling position:
1. 𝐒𝐭𝐫𝐚𝐢𝐠𝐡𝐭 𝐞𝐥𝐛𝐨𝐰𝐬. Why?
We want the 𝘸𝘦𝘪𝘨𝘩𝘵 𝘰𝘧 our 𝘶𝘱𝘱𝘦𝘳 𝘣𝘰𝘥𝘺 𝘵𝘰 𝘤𝘰𝘮𝘱𝘳𝘦𝘴𝘴 𝘵𝘩𝘦 𝘤𝘩𝘦𝘴𝘵 𝘨𝘳𝘦𝘢𝘵𝘦𝘳 𝘵𝘩𝘢𝘯 𝟸 𝘪𝘯𝘤𝘩𝘦𝘴 in adults.
Straight elbows 𝘳𝘦𝘥𝘶𝘤𝘦 the compressor trying to use the 𝘴𝘵𝘳𝘦𝘯𝘨𝘵𝘩 𝘪𝘯 𝘵𝘩𝘦𝘪𝘳 𝘢𝘳𝘮𝘴 to compress.
Additionally, 𝘣𝘦𝘯𝘵 𝘦𝘭𝘣𝘰𝘸𝘴 𝘢𝘣𝘴𝘰𝘳𝘣 some of the 𝘥𝘰𝘸𝘯𝘸𝘢𝘳𝘥 𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦 reducing downward pressure exerted on the chest. 𝘉𝘰𝘵𝘩 𝘰𝘧 𝘸𝘩𝘪𝘤𝘩 𝘸𝘪𝘭𝘭 𝘤𝘢𝘶𝘴𝘦 𝘦𝘢𝘳𝘭𝘺 𝘧𝘢𝘵𝘪𝘨𝘶𝘦 𝘢𝘯𝘥 𝘥𝘪𝘧𝘧𝘪𝘤𝘶𝘭𝘵𝘺 𝘮𝘢𝘪𝘯𝘵𝘢𝘪𝘯𝘪𝘯𝘨 𝘥𝘦𝘱𝘵𝘩.
2. 𝐒𝐡𝐨𝐮𝐥𝐝𝐞𝐫𝐬 𝐨𝐯𝐞𝐫 𝐬𝐭𝐞𝐫𝐧𝐮𝐦. Why?
Ensuring that shoulders are over the sternum 𝘨𝘪𝘷𝘦𝘴 𝘵𝘩𝘦 𝘤𝘰𝘮𝘱𝘳𝘦𝘴𝘴𝘰𝘳 𝘵𝘩𝘦 𝘭𝘦𝘷𝘦𝘳𝘢𝘨𝘦 𝘯𝘦𝘦𝘥𝘦𝘥 to get deep enough compressions.
The compressor needs to properly support their upper body and not lean on the person needing compressions otherwise full chest recoil can not be achieved.
Also, this will help ensure that our shoulders can get over then sternum.
4. 𝐇𝐞𝐚𝐥 𝐨𝐟 𝐡𝐚𝐧𝐝 𝐢𝐬 𝐨𝐧 𝐬𝐭𝐞𝐫𝐧𝐮𝐦. Why?
During compressions the 𝘴𝘵𝘦𝘳𝘯𝘶𝘮 (breast bone) is the 𝘣𝘰𝘯𝘦 𝘸𝘦 𝘸𝘦 𝘴𝘩𝘰𝘶𝘭𝘥 𝘣𝘦 𝘤𝘰𝘮𝘱𝘳𝘦𝘴𝘴𝘪𝘯𝘨. 𝘚𝘪𝘯𝘤𝘦 𝘵𝘩𝘦 𝘳𝘪𝘣𝘴 𝘢𝘳𝘦 𝘢𝘵𝘵𝘢𝘤𝘩𝘦𝘥 𝘵𝘰 𝘵𝘩𝘦 𝘴𝘵𝘦𝘳𝘯𝘶𝘮, 𝘵𝘩𝘦 𝘳𝘪𝘣 𝘤𝘢𝘨𝘦 𝘸𝘪𝘭𝘭 𝘢𝘭𝘴𝘰 𝘤𝘰𝘮𝘱𝘳𝘦𝘴𝘴 𝘸𝘪𝘵𝘩 𝘥𝘰𝘸𝘯𝘸𝘢𝘳𝘥 𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦.
This facilitates compressing a larger portion of the chest cavity resulting in a better squeeze of the organs (especially the heart) and pumping of more blood.
When compressing, the 𝘸𝘦𝘪𝘨𝘩𝘵 of the compressors body 𝘧𝘳𝘰𝘮 𝘵𝘩𝘦 𝘥𝘰𝘸𝘯𝘸𝘢𝘳𝘥 𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦, 𝘸𝘪𝘭𝘭 𝘣𝘦 𝘪𝘯 𝘵𝘩𝘦 𝘩𝘦𝘢𝘭 𝘰𝘧 their 𝘩𝘢𝘯𝘥….therefore, the chest will compress wherever the heel of the hand is.
So….if the heel of the hand is on the right or left side of the sternum then a smaller portion of the chest cavity will compress leading less blood being pumped.
In all situtions....do the best you can!
THANK YOU
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