Effect of bed width on the quality of compressions in simulated resuscitation: a randomized crossover manikin study.

Objectives: To investigate the effects of bed width on the quality of chest compressions during simulated in-hospital resuscitation. Methods: Each candidate performed two 2-minute cycles of compression-only cardiopulmonary resuscitation on an adult manikin placed on either an emergency stretcher (narrow bed) or a standard hospital bed (wide bed) in random order at 1 day intervals. We conducted subjective assessments of cardiopulmonary resuscitation quality and rescuer fatigue at the end of each session, using surveys. Results: There were no significant differences between narrow and wide bed sessions in either mean depth or the percentage of compressions with adequate depth (P = .56 and .58, respectively). The mean rate of compressions and the percentage of compressions with adequate rate were also similar between sessions (P = .24 and .27, respectively). However, the percentage of correct hand position and complete chest recoil was significantly higher in the narrow bed session than in the wide bed session (P = .02 and .02, respectively). In addition, survey results showed that rescuers felt more comfortable and less exhausted in the narrow bed session compared with the wide bed session (P < .001 and < .001). Conclusions: When rescuers performed chest compressions on an emergency stretcher, chest compression quality increased, and the fatigue of rescuers decreased compared with a standard hospital bed. Therefore, we propose a narrow bed for critically ill inpatients with high risk of cardiac arrest. (C) 2016 Elsevier Inc. All rights reserved.