• Sung Soo Choi, Seong-Woo Yun, Byung Kook Lee, Kyung Woon Jeung, Kyoung Hwan Song, Chang-Hee Lee, Jung Soo Park, Ji Yeon Jeong, and Sang Yeol Shin.
• Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
• Am J Emerg Med. 2015 Mar 1;33(3):373-7.

PurposeTo improve the quality of chest compression (CC), we developed the assistant-push method, whereby the second rescuer pushes the back of the chest compressor during CC. We investigated the effectiveness and feasibility of assistant push in achieving and maintaining the CC quality.MethodsThis was a randomized crossover trial in which 41 subjects randomly performed both of standard CC (single-rescuer group) and CC with instructor-driven assistant push (assistant-push group) in different order. Each session of CC was performed for 2 minutes using a manikin. Subjects were also assigned to both roles of chest compressor and assistant and together performed CC with subject-driven assistant push. Depth of CC, compression to recoil ratio, duty cycle, and rate of incomplete recoil were quantified.ResultsThe mean depth of CC (57.0 [56.0-59.0] vs 55.0 [49.5-57.5], P < .001) was significantly deeper, and the compression force (33.8 [29.3-36.4] vs 23.3 [20.4-25.3], P < .001) was stronger in the assistant-push group. The ratio of compression to recoil, duty cycle, and rate of incomplete chest recoil were comparable between the 2 groups. The CC depth in the single-rescuer group decreased significantly every 30 seconds, whereas in the assistant-push group, it was comparable at 60- and 90-second time points (P = .004). The subject assistant-push group performed CCs at a depth comparable with that of the instructor assistant-push group.ConclusionThe assistant-push method improved the depth of CC and attenuated its decline, eventually helping maintain adequate CC depth over time. Subjects were able to feasibly learn assistant push and performed effectively.Copyright © 2014 Elsevier Inc. All rights reserved.

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