The effect of differing support surfaces on the efficacy of chest compressions using a resuscitation manikin model

Aim: External chest compression (ECC) efficacy is influenced by factors inc luding the surface supporting the patient. Air-filled support surfaces are deflated for cardiopulmonary resuscitation, with little evidence to substan tiate this. We investigated the effect that differing support surfaces had on ECC efficacy using a CPR manikin model. Methodology: Four participants c arried out four cycles of ECC with an assistant ventilating. The subjects w ere blinded to the seven support surfaces and the order was randomised. For each participant/surface combination, ECC variables and the participants' perceptions were measured. Results: Participants produced effective ECC wit h the manikin on the floor (mean proportion correct, 94.5%; mean depth, 42. 5 mm). Compared with the floor: the proportion of correct ECC was less for the overlay inflated (P < 0.05); the depth of ECC was less effective (30-37 mm) for the overlay inflated/deflated and low-air-loss inflated and foam m attresses (P < 0.05). The foam mattress, overlay inflated/deflated, and low -air-loss inflated were perceived as being less stable and as having reduce d ECC efficacy compared with the floor. There was no difference or agreemen t, regarding subjects' perceptions or ECC variables, between the support su rfaces or between inflated/deflated air-filled support surfaces. Conclusion : The efficacy of ECC is affected by the support surfaces. There seems litt le evidence to substantiate deflating all air-filled support surfaces for C PR. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.