Kneeling Posture With a Kneeling Stool During Cardiopulmonary Resuscitation in Hospital
Condition: Cardiac Arrest
MeSH terms: Heart Arrest
Study type: Interventional

Summary: 
      To perform chest compression (CC) in the kneeling posture in hospital, we designed a stage
      with stairs, named the 'kneeling stool', on which a CC performer kneels beside a patient on a
      bed.This work is the validation study to demonstrate that the kneeling stool could be used
      for high quality hospital cardiopulmonary resuscitation (CPR) with the kneeling posture. We
      hypothesized that the quality of chest compression with a kneeling posture using the kneeling
      stool is equal to or superior to CC with a standing posture using the height adjustment
      mechanism of the bed.
    

Detailed description: 
      We designed and implemented the kneeling stool to perform CPR with the kneeling posture for a
      patient on a bed. The frame is constructed of an aluminum alloy. The size is 570 mm (width) x
      598 mm (depth) x 600 mm (height). The weight is 9.3 kg, which is easily moved as needed. For
      easy rotation between rescuers, a step plate was inserted. To prevent pain to the knees of
      the kneeling CC performer, a 40mmthick sponge cushion was placed on the top plate and fixed
      to the frame.

      A standard hospital bed frame (Transport stretcher®, 760 x2110 mm, 228 kg, Stryker Co.,
      Kalamazoo, Michigan, USA), a foam mattress (660 x 920 x 80 mm, soft foam with polyurethane
      coverage, Stryker Co., USA), a backboard (450 ×600 ×10 mm, 3 kg Lifeline Plastic, Sung Shim
      Medical Co., Bucheon, Korea), and a step stool (395 x 450 x 410 mm, Gunica Co.,
      Gyeongsangnam-do, Korea) were used in the experiment. A Resusci Annie Modular System Skill
      Reporter® manikin (Laerdal Medical, Orpington, UK) was used to perform CPR in the
      evaluations. We added weight to the manikin to equal 34 kg for simulating the upper body
      weight of an adult human as in a previous study.

      Data collection The participants were divided into two groups by random drawing. Each
      performer in the first group knelt on the kneeling stool beside the manikin on a bed and
      compressed the chest of the manikin (CCs with a kneeling posture, PK).Each performer in the
      second group stood on a step stool beside the manikin on a bed and compressed the chest of
      the manikin (CCs with a standing posture, PS). When the performer stood beside the manikin on
      a bed, the height of the manikin's back was adjusted in height to the knee level of the
      provider using the step stool and the bed height adjustment mechanism. All the participants
      performed continuous CCs for 5 minutes without audio-visual feedback. After 2 weeks, the
      posture used for the CCs by each group was changed. Each participant recorded his/her fatigue
      and pain levels on a visual analogue scale (VAS, score 0 indicates "no pain and fatigue" and
      score 10 indicates "unbearable pain and fatigue") for each minute during 5 minutes of CCs.
      After conclusion of the experiment, the participants selected a preferred CC posture in terms
      of the safety and the quality of the CCs.
    

Intervention name(s): Chest compression with a step stool; Chest compression with a kneeling stool
Intervention type(s): Device; Device
Intervention description(s): Participants compress the chest of a manikin with a standing posture using a step stool during 5 minutes; Participants compress the chest of a manikin with kneeling posture using a kneeling stool during 5 minutes
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Basic Science
Keywords: Cardiopulmonary resuscitation; Chest compression; Advanced cardiac life support; Posture