Abstract Body: Background:
Proper hand placement is critical for high-quality chest compressions. Traditional training uses torso manikins with a head and neck, although prohibitive cost has led to development of smaller alternative devices without landmarks. cardiacSTAR is a serious, interactive game that teaches hands-only CPR to lay rescuers using a simplified manikin without a head/neck. There is concern that omitting anatomical landmarks may impair proper hand placement. However, it is unknown whether torso manikins consistently lead to correct hand placement—or whether simplified devices hinder it.
Hypothesis:
We hypothesized that learners trained using cardiacSTAR would demonstrate more accurate hand placement compared to students trained using AHA “CPR in Schools” paired with inflatable torso manikins (Mini Anne, Laerdal).
Methods:
Ninth-grade students (n=47) were trained in CPR using one of two methods: 1) AHA® “CPR in Schools” paired with inflatable Mini Anne (Laerdal®) torso manikins (n=26), or 2) cardiacSTAR training paired with a novel compression device without head/neck (n=21). Immediately following training, students applied washable ink to gloved hands and placed their hands to perform CPR on a full torso manikin (Little Anne, Laerdal®). Photographic analysis classified handprints as correct or incorrect in two dimensions: alignment with the internipple line (≤75% of the palm positioned above or below the line) and sternum (within 1.5 inches of midline) (Figure 1).
Results:
In this pilot study, there was a trend towards a greater proportion of learners in the cardiacSTAR group demonstrating correct two-dimensional hand placement compared to the AHA group (62.0% vs. 30.8%, p = 0.0658), with non-significant trends towards greater accuracy in both individual dimensions (internipple line 81% v 65.4%, p=0.3908; sternum 66.7% v. 50%, p=0.3941) (Figure 2, Table 1). More learners in both groups were off-center of the sternum rather than above or below the nipples.
Conclusion:
In this pilot study, training with cardiacSTAR and no head/neck manikins resulted in a trend towards better hand placement accuracy than traditional training with inflatable torso manikins. These findings suggest that novel devices without head/neck do not necessarily impair proper hand placement, when paired with realistic and detailed instruction.