Thursday, March 17, 2016

Leg-Heel CPR for nurses with disabilities...Why not?

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). 

"The test subjects were all 35 years old or older, and half of the cohort was between 50-80 years old. Fewer than 20 percent of the cohort was able to perform two-inch manual chest compressions for four minutes at the required one hundred per minute or higher rate.

In contrast, more than 60 percent of study participants were able to perform two-inch pedal compressions for 10 minutes at that rate—and those subjects felt that they could easily perform adequate depth and rate pedal compressions for another extended period, if necessary." 

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

Sudden Cardiac Arrest Foundation (SCAF) (2012) Can heel CPR help?

For more information visit:

Wednesday, March 9, 2016


Are you struggling with life issues? Or, health or 

disability related challenges?

Have you lost a job?

Are you going back to school?

Do you have a gnawing hunger for something?

Is your life dry?

Do you need to take a bite out of life?

Do you have a shirt with a deer on it?

Do you need some timeless advice from the best life coach?

Today is your lucky day! Here is a free session with Cookie Monster.

Please share your thoughts and pass the milk!


Wednesday, March 2, 2016

Playlist for nurses and nursing students with disabilities

I asked a group of nurses and nursing students with disabilities the following questions:

Do you have a favorite song? Music video? Special lyrics?What type of music helps you stay motivated to charge ahead in spite of your personal challenge? 

The following "playlist" was developed from the responses. If you need some inspiration, these songs may help!

"Hit Me with Your Best Shot" by Pat Benatar

"Under Pressure" by Queen and David Bowie
American Sign Langage Interpretation by Amber Galloway Gallego

"My shot" From "Hamilton" by Lin-Manuel Miranda, Anthony Ramos, Daveed Diggs, Okieriete Onaodowan, Leslie Odom, Jr., the Original Broadway Cast.
American Sign Language Interpretation by Maddie Stengel

"Wait for it" From Hamilton" Leslie Odom, Jr., the Original Broadway Cast.
American Sign Language Interpretation by E Karll

"Roar" by Katy Perry
American Sign Language Interpretation by Rosa Lee Timm

"Respect" by Aretha Franklin
American Sign Language Interpretation by amrobi314

"I will survive" by Gloria Gaynor
American Sign Language  Interpretation by Soph 1951
British Sign Language version by Gordon Newton Wylie-Black

"Beautiful" by Christina Aguilera
American Sign Language Interpretation by Dpanvideos

"Casting Crowns: Praise you in the storm"
by Stephen Henderson
American Sign Language Interpretation by Soph 1951

"Secrets" by Mary Lambert
          American Sign Langage Interpretation by Amber                    Galloway Gallego 

"Overcomer" by Mandisa
American Sign Language Interpretation by Ayorkor Adjei

My personal favorite...........
"I say a little prayer" by Aretha Franklin
American Sign Language  Interpretation by Bethany Smith

What do you think? Do any of these songs help you? Would you add to the list?

Love to read your responses.

With thanks,