Identifying the optimal hand placement site for chest compression by measuring hand width and sternal length in young adults

Abstract

Objective: There are no specific guidelines regarding the exact hand placement location for effective chest compressions. This study was designed to identify the optimal hand placement site over the chest during cardiopulmonary resuscitation (CPR). Methods: The sternal length (SL) of young Korean adults was measured as the distance from the suprasternal notch (SN) to the lower end of the sternum. In addition, the heel width of the hand (H) was measured 1 cm (H1) and 2 cm (H2) distal to the proximal end of the carpal bones. Results: A total of 300 men and 300 women were enrolled. SL positively correlated with height (R-2=14.2), weight (R-2=15.3), BMI (R-2=10.3), H1 (R-2=3.4), and H2 (R-2=5.0). Mean H2 and half of the SL (SL/2) for the subgroups were M 8.4 and 10.1 cm, M' 8.3 and 9.7 cm, W7.6 and 10.1 cm, and W' 7.4 and 9.5 cm, respectively (M, men taller than the mean; M', men shorter than the mean; W, women taller than the mean; W', women shorter than the mean). Mean H2 in men was 1.1 to 1.6 cm shorter than SL/2, whereas mean H2 in women was 2.2 to 2.9 cm shorter than SL/2. Conclusions: To find the most optimal chest compression point, from the patients' left side, CPR providers need to palpate the SN using the right little finger and placing the left heel one heel width (H2) from the SN. From the patient's right side, CPR providers should use the left little finger to palpate the SN and place the right heel one heel width (H2) from the SN. (C) 2015 Elsevier Inc. All rights reserved.