Author(s): MORGADO, J., BHUDARALLY, M., FEBRA, C., PEREIRA, H., PALMEIRA, A., ALEIXO, P., Institution: UNIVERSIDADE LUSÓFONA DE HUMANIDADES E TECNOLOGIAS, Country: PORTUGAL, Abstract-ID: 1817

INTRODUCTION:
The posture and position of rescuers, as well as the height at which a patient is positioned during chest compressions, significantly influence the efficacy and efficiency of cardiopulmonary resuscitation (CPR). Despite this, there are no established guidelines regarding optimal rescuer posture or patient height placement, highlighting the need to systematize existing knowledge and explore the potential benefits of exercise interventions on CPR performance.

This systematic review aims to evaluate the impact of rescuers posture and the height at which a patient or manikin is positioned during chest compressions. It focuses on mechanical and physiological fatigue indicators to determine how these factors affect the efficacy and efficiency of CPR.
METHODS:
Adhering to PRISMA guidelines and registered with PROSPERO, the review included peer-reviewed articles that compared different rescuer postures and patient heights during chest compressions. Databases such as MEDLINE Complete, SPORTDiscus, Cochrane Reviews, and CINAHL Complete were searched. The methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies.
RESULTS:
The search yielded 6543 articles, with 34 meeting inclusion criteria. All studies were observational, utilized manikins, and were deemed weak in methodological quality. No studies specifically addressed exercise intervention impacts. The kneeling posture was found to enhance the efficacy and efficiency of chest compressions compared to standing, particularly when performed on the ground rather than a bed. Research on optimal patient height relative to rescuer anthropometrics remains scarce. The contact hand does not significantly impact compression quality, and chest compressions should not be performed while moving.
CONCLUSION:
The review found no studies on exercise interventions effects on CPR efficiency. There are no specific recommendations for rescuer posture based on patient height. Fitness levels may influence the duration of effective chest compressions, as physical function, muscle strength, mass and morphology tend to decline with age. Understanding physiological effort and recovery could optimize CPR techniques. Future research should investigate how exercise programs can affect CPR efficiency and fatigue in first aiders.