Step stool helps shorter rescuers do better CPR

Amid all the technology used in hospitals to keep critically ill people alive, doctors are looking at whether the low-tech step stool can make a meaningful difference.

When a hospital patient goes into cardiac arrest, doctors and nurses perform cardiopulmonary resuscitation, or CPR, which includes chest compressions that need to be deep enough to move blood out of the heart and toward the rest of the body.

But when the rescuer is short and the victim is on a hospital bed there's a problem: It's hard to get enough leverage to press down on the chest, and the rescuer has to rely on upper-body strength.

It would seem logical that giving rescuers a boost with a step stool could help.

But equipping every hospital crash cart with a step stool is an expense, noted Dr. Dana P. Edelson of the University of Chicago Medical Center, the lead researcher on the new study.

A stool like the one in your kitchen is not good enough: It has to be of the sturdy, industrial variety, Edelson told Reuters Health.

So hospitals will first want to know whether step stools actually improve CPR quality.

To find out, Edelson and her colleagues had 50 people at their hospital, all trained in CPR, perform chest compressions on a mannequin. Each did two two-minute rounds while standing on the floor, and two while on a nine-inch-high step stool.

Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. The American Heart Association recommends that everyone — untrained bystanders and medical personnel alike — begin CPR with chest compressions.

It's far better to do something than to do nothing at all if you're fearful that your knowledge or abilities aren't 100 percent complete. Remember, the difference between your doing something and doing nothing could be someone's life.

Here's advice from the American Heart Association:

- Untrained. If you're not trained in CPR, then provide hands-only CPR. That means uninterrupted chest compressions of about 100 a minute until paramedics arrive (described in more detail below). You don't need to try rescue breathing.
- Trained, and ready to go. If you're well trained and confident in your ability, begin with chest compressions instead of first checking the airway and doing rescue breathing. Start CPR with 30 chest compressions before checking the airway and giving rescue breaths.
- Trained, but rusty. If you've previously received CPR training but you're not confident in your abilities, then just do chest compressions at a rate of about 100 a minute.

The mannequin was outfitted with a sensor that recorded the depth of the chest compressions and other measures of CPR quality.