A comparison between over the head CPR and standard CPR

Gavin Perkins, BTF Stephenson, [No Value] [No Value], Fang Gao Smith

Research output: Contribution to journalArticle

41 Citations (Scopus)


BACKGROUND: Standard cardiopulmonary resuscitation (CPR) is performed by kneeling adjacent to the side of the casualty. In certain circumstances it may be difficult or impossible to perform CPR in this position, for example in confined spaces such as a narrow corridor, aircraft or train gangway. The aim of this study was to investigate the technique of over-the-head CPR (OTH CPR), where the CPR provider kneels above the casualty and performs chest compressions OTH of the casualty. METHODS: Twenty volunteers were randomised to a cross over trial where they performed standard and OTH CPR at a 7-day interval. Compression and ventilation variables were recorded on the Laerdal Resusci Annie VAM system. RESULTS: Chest compression depth and ventilation volume declined over time (0-3 min P <0.001). There was no difference in compression rate, depth, duty cycle or ventilation rate, inflation rate and ventilation volume between techniques. Hand position was incorrect more frequently in the standard compared to the OTH group (incorrect compressions 300 versus 76, respectively, P <0.001) due principally to a greater proportion of low positioned compressions in the standard CPR group. CONCLUSION: OTH CPR appears equally effective as standard CPR with some marginal advantages in correct hand placement. We suggest that in situations where it is not possible to perform standard CPR, OTH CPR may be considered as a suitable alternative.
Original languageEnglish
Pages (from-to)155-161
Number of pages7
Publication statusPublished - 1 May 2004


  • safety
  • chest compression
  • cardiopulmonary resuscitation
  • basic airway management
  • basic life support


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