Impact of bed height on the biomechanics of healthcare professionals during chest compressions on the neonate: a descriptive pilot study

Abstract

ObjectivesThe biomechanics of the healthcare professionals (HCPs) performing the life-saving intervention of chest compressions in the neonatal population is poorly understood. The aim of this pilot study was to describe the variations in body position at a self-selected and a predetermined bed height during neonatal chest compressions. Measures of joint angles, time to postural sway and number of postural adjustments were chosen as indices for the stability of the HCP’s position.SettingData were collected at a simulation-based research centre in which the patient care environment was replicated.ParticipantsHCPs with varying roles working in the neonatal intensive care unit and holding a current Neonatal Resuscitation Program Provider certification were recruited for this study.InterventionsFifteen HCPs performed two trials of chest compressions, each lasting 2 min, at a predetermined bed height and a self-selected bed height. Trials were video recorded, capturing upper and lower body movements. Videos were analysed for time to postural sway and number of postural adjustments. Joint angles were measured at the start and end of each trial.ResultsA statistically significant difference was found between the two bed height conditions for number of postural adjustments (p=0.02). While not statistically significant, time postural sway was increased in the choice bed height condition (85 s) compared with the predetermined bed height (45 s). After 30 s of chest compressions, mean shoulder and knee angles were smaller for choice bed height (p=0.03, 95% CI Lower=−12.14, Upper=−0.68 and p=0.05, 95% CI Lower=3.43, Upper=0.01, respectively). After 1 min and 45 s of chest compressions, mean wrist angles were smaller in the choice bed height condition (p=0.01, 95% CI Lower=−9.20, Upper=−1.22), stride length decreased between the 30 s and 1 min 45 s marks of the chest compressions in the predetermined height condition (p=0.02).