Some nurses and nursing students with disabilities are unable to perform CPR with two hands (nurses with one hand or arm, cerebral palsy, or paralysis).
Responses to requests for disability-related accommodation for CPR classes can vary from one instructor/provider to another.
Should we consider the leg-heel method as a reasonable accommodation?
Positive results of a pilot study of the “leg-heel method” were reported in JAMA 38 years ago (Billfield & Regula (1978).
In 2012, Fernando Perez, MD, and Robert H. Trenkamp, Jr., EMT-P, presented their research findings at the American Heart Association Resuscitation Science Symposium. Perez & Trenkamp studied the duration an adult could maintain two-inch deep chest compressions at a rate of at least 100 per minute using “Hands-Only” and then Pedal Compressions (“Heel CPR”) in two sequential tests (SCAF, 2012).
In an article published in the American Journal of Emergency Medicine, Trenkamp & Perez (2015) "reported that heel compressions are useful in situations where a lone rescuer cannot get down on the floor, cannot compress the chest to guideline depth because of an infirmity or lack of weight, or becomes too tired to continue manual compressions. Heel compressions significantly increase the bystander population's ability to provide effective, uninterrupted compressions until EMS arrival."
Do these findings merit a closer look?
Could this approach to CPR be considered as a reasonable accommodation for CPR certification for some nurses with disabilities? For example, nurses working in home health or community settings?
Would a write-in campaign to the American Heart Association and American Red Cross help?
Appreciate reading your comments about this important topic.
Billfield, L., Regula, G. (1978). A new technique for external heart compression. Journal of the American Medical Association, 239(23): 2468-2469. doi:10.1001/jama.1978.03280500064023.
Durham, J. (2013). CPR Pedal-Heel Compressions. Frontline First Aid and Emergency Training.
Trenkamp, R., Perez, F. (2015, October). Heel compressions quadruple the number of bystanders who can perform CPR for 10 minutes. The American Journal of Emergency Medicine, 33(10):1449-1453. Retrieved at http://www.ajemjournal.com/article/S0735-6757(15)00560-4/abstract
Sudden Cardiac Arrest Foundation (SCAF) (2012) Can heel CPR help?
For more information visit: www.slicc.org