A Comparison of Two Stool Positions for Stabilizing a Dental Chair During CPR
Most dental chairs lack sufficient stability to perform effective manual chest compression (MCC) during cardiopulmonary resuscitation (CPR). A stabilizing stool can significantly reduce backrest vertical displacement in all chair types; however, a severely curved exterior backrest may negatively impact the stool's effectiveness. This study evaluated the efficacy of 2 stool positions for stabilizing a dental chair during MCC. Chest compressions were performed on a manikin positioned in a dental chair while vertical displacement of the chair backrest during MCC was recorded using video and measured. Vertical displacement data were captured with no stool and with a stabilizing stool in 2 different positions. Reduction ratios were calculated to evaluate the effectiveness of the 2 stool positions. With no stool, the backrest median (interquartile range) vertical displacement during chest compressions was 16.5 (2.5) mm as compared with 12.0 (1.5) mm for the stabilizing stool positioned under the area of MCC and 8.5 (1.0) mm under the shoulders. The stool positioned under the shoulders produced a significantly increased calculated reduction ratio of 48% (14%) compared with 27% (20%) under the area of MCC (P < .001). Positioning a stabilizing stool under the shoulders was more effective at reducing vertical displacement of the dental chair backrest during chest compressions than positioning the stool under the area of MCC.Objective:
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Manikin setup and positioning of the stabilizing stool. Upper end of the manikin torso was aligned with the top edge of the backrest (A; red line). The superior surface of the backrest under the lower half of the manikin sternum was positioned horizontally using a levelling instrument. The edge of the stool's seating surface was set to touch the backrest vertically under the area for manual chest compressions (A; green line). The center of the manikin's chest (B; red ellipse) was the hand position during chest compressions. The stool was set to touch the backrest vertically under the shoulders (C; blue line).
Measuring vertical displacement and chest compression depth. A metal indicator (point P; A) was made parallel to the floor with a leveling gauge and secured to the inferior surface of the dental chair directly under the area for manual chest compression (MCC) next to a fixed vertical-measurement instrument (B). The distance of point P relative to the inferior surface of the backrest remained fixed. Chest compression depth was assessed using the manikin's SkillReporter system (C) with green lights indicating chest compression depths of 5.1–6.0 cm and red lights for 3.8–5.0 cm.
Vertical displacement measurements for each participant. Effect of the stabilizing stool on the backrest vertical displacement measurements during chest compressions. The thick lines represent median values, the boxes represent interquartile ranges, over and under lines represent date ranges, and circles represent outliers.
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