The Ability to Provide Quality Chest Compressions Over Lacrosse Shoulder Pads

Abstract

Context:  Performance of quality cardiopulmonary resuscitation is essential for improving patient outcomes. Performing compressions over football equipment inhibits compression depth and rate, but lacrosse equipment has not yet been studied. Objective:  To assess the effect of lacrosse shoulder pads on the ability to provide quality chest compressions on simulation manikins. Design:  Crossover study. Setting:  Simulation laboratory. Patients or Other Participants:  Thirty-six athletic trainers (12 men: age = 33.3 ± 9.7 years; 24 women: age = 33.4 ± 9.8 years). Main Outcome Measure(s):  No shoulder pads (NSP), Warrior Burn Hitman shoulder pads (WSP), and STX Cell II shoulder pads (SSP) were investigated. Outcomes were chest-compression depth (millimeters), rate (compressions per minute), rating of perceived exertion (0−10), hand-placement accuracy (%), and chest recoil (%). Results:  We observed a difference in mean compression depth among shoulder-pad conditions (F2,213 = 3.73, P = .03, ω2 = 0.03), with a shallower depth during the WSP (54.1 ± 5.8 mm) than the NSP (56.8 ± 5.7 mm; P = .02) trials. However, no differences were found in mean compression rate (F2,213 = 0.87, P = .42, ω2 = 0.001, 1–β = .20). We noted a difference in rating of perceived exertion scores (F2,213 = 16.41, P < .001, ω2 = 0.12). Compressions were more difficult during the SSP condition (4.1 ± 1.3) than during the NSP (2.9 ± 1.2; P < .001) and WSP (3.3 ± 1.1; P = .002) conditions. A difference was present in hand-placement accuracy among the 3 shoulder-pad conditions (χ22 = 11.14, P = .004). Hand-placement accuracy was better in the NSP than the SSP condition (P = .002) and the SSP than the WSP condition (P = .001). Conclusions:  Lacrosse shoulder pads did not inhibit the ability to administer chest compressions with adequate rate and depth. With appropriate training to improve hand placement, the pads may be left in place while cardiopulmonary resuscitation is initiated during sudden cardiac arrest.