Hands at work: A randomised cross-over mannequin-based trial exploring the impact of hand preference of health care professionals on effectiveness of chest compressions

Aim and background: There are various theories regarding the ideal hand to be in contact with chest during chest compressions when healthcare professionals and medical students perform cardiopulmonary resuscitation (CPR). Our study aimed to compare the impact of preferred versus non-preferred hand placement on chest on the CPR quality. Methodology: The volunteers were randomised to place their preferred (P)/non-preferred (NP) hand over sternum for the first session and switch hands for the second. Participants performed 2 min of uninterrupted chest compressions, followed by a 2-minute break and another 2 min of chest compressions on Laerdel QCPR Little Anne® mannequin with auditory feedback. The CPR parameters were analysed using QCPR mobile application. Comfort was assessed using 5-point Likert scale. Results: Among the 82 volunteers, 51 participants (62.2%) preferred their dominant hand to be in contact with the chest. Comparable results were seen with mean QCPR score, rate of compression, mean depth and good recoil percentage. The NP set had higher adequate depth percentage (94.8 +/- 13.7) than the P set (92.3 +/- 19.9) (p = 0.042), but participants were more comfortable using their preferred hand over chest (p = 0.0001). Conclusion: Rescuer performance during chest compressions may not be impacted by whether the preferred hand or non-preferred hand of the provider is in contact with sternum.