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- W2130170897 abstract "I was very interested to read the study by Dr Andrew Owen and his colleagues on locating the hand position for chest compression.1Owen A, Harvey P, Kocierz L, et al. A randomised control trial comparing two techniques for locating chest compression hand position in adult basic life support. doi:10.1016/j.resuscitation.2011.02.038.Google Scholar They conclude that the landmark technique (as in the 2000 Guidelines) leads to more accurate hand placement than the ‘simple’ method of teaching (‘place your hands in the centre of the chest’; as in the 2005 Guidelines), without any increase in hands-off time.The simple method was recommended in the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations2International Liaison Committee on and Resuscitation International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Part 2: Adult basic life support.Resuscitation. 2005; 67: 187-201Abstract Full Text Full Text PDF PubMed Scopus (200) Google Scholar on the strength of a single published study,3Handley A.J. Teaching hand placement for chest compression—a simpler technique.Resuscitation. 2002; 53: 29-36Abstract Full Text Full Text PDF PubMed Scopus (60) Google Scholar and it is high time that this was revisited. Before concluding, however, that the landmark technique should be brought back into the guidelines, I believe it is important to look very closely at this new study.First, the authors themselves highlight that those studied were highly motivated and intelligent medical students, albeit at an early stage of their training, whereas many of those taught BLS are lay members of the public: the simple method is designed to be simple to teach to all.Second, although the trial and control groups were determined by randomisation, there was no pre-test assessment of hand position accuracy or hands-off time to confirm that the groups were balanced: it is difficult to follow the authors’ contention that such assessments ‘would have potential to cause bias’.Third, and most important, those randomised to the landmark technique received additional training, whereas those in the control group had none: this alone would seem likely to lead to better performance by the trial group.Although I welcome this challenge to the existing BLS guidelines, I encourage further studies of the two methods (and, maybe, others) to be carried out to ensure a solid evidence base before any change is made to the guidelines.Conflict of interest statementThe author is sole author of one of the referenced papers. I was very interested to read the study by Dr Andrew Owen and his colleagues on locating the hand position for chest compression.1Owen A, Harvey P, Kocierz L, et al. A randomised control trial comparing two techniques for locating chest compression hand position in adult basic life support. doi:10.1016/j.resuscitation.2011.02.038.Google Scholar They conclude that the landmark technique (as in the 2000 Guidelines) leads to more accurate hand placement than the ‘simple’ method of teaching (‘place your hands in the centre of the chest’; as in the 2005 Guidelines), without any increase in hands-off time. The simple method was recommended in the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations2International Liaison Committee on and Resuscitation International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Part 2: Adult basic life support.Resuscitation. 2005; 67: 187-201Abstract Full Text Full Text PDF PubMed Scopus (200) Google Scholar on the strength of a single published study,3Handley A.J. Teaching hand placement for chest compression—a simpler technique.Resuscitation. 2002; 53: 29-36Abstract Full Text Full Text PDF PubMed Scopus (60) Google Scholar and it is high time that this was revisited. Before concluding, however, that the landmark technique should be brought back into the guidelines, I believe it is important to look very closely at this new study. First, the authors themselves highlight that those studied were highly motivated and intelligent medical students, albeit at an early stage of their training, whereas many of those taught BLS are lay members of the public: the simple method is designed to be simple to teach to all. Second, although the trial and control groups were determined by randomisation, there was no pre-test assessment of hand position accuracy or hands-off time to confirm that the groups were balanced: it is difficult to follow the authors’ contention that such assessments ‘would have potential to cause bias’. Third, and most important, those randomised to the landmark technique received additional training, whereas those in the control group had none: this alone would seem likely to lead to better performance by the trial group. Although I welcome this challenge to the existing BLS guidelines, I encourage further studies of the two methods (and, maybe, others) to be carried out to ensure a solid evidence base before any change is made to the guidelines. Conflict of interest statementThe author is sole author of one of the referenced papers. The author is sole author of one of the referenced papers." @default.
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- W2130170897 date "2011-08-01" @default.
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- W2130170897 title "Hand position for chest compression" @default.
- W2130170897 cites W1978254828 @default.
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- W2130170897 doi "https://doi.org/10.1016/j.resuscitation.2011.04.024" @default.
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