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How to Position Your Hand for CPR?

One of the driving factors that determine the effectiveness of CPR is the proper hand placement. While performing hands-only CPR on the person, the success rate of survival and effectiveness of CPR are entirely dependent on the hand position.

Here, we will discuss precisely where to put your hands for CPR, how to posture your body, and some pointers to guarantee you are performing high-quality chest compressions as part of this critical emergency procedure.

What is Hand Position in CPR?

The way you place your hand above the chest before starting chest compression in a certain position is known as hand position in CPR. Proper hand placement in CPR before applying chest compression would result in effective CPR.

Hand placement in CPR is a very crucial part when performing hands-only CPR. It would lead to various complications if performed wrongly. Ineffective chest compressions due to incorrect positioning can significantly reduce the chances of survival. Ineffective chest compressions due to incorrect positioning can significantly reduce the chances of survival. So one should perform CPR only if the person has taken some aid training related to CPR from healthcare professionals, is CPR certified or and have personally practiced both chest compressions and rescue breaths on mannequins or other training devices.

Importance of Correct CPR Hand Position in Adults, Children, and Infants

To execute CPR by providing high-quality chest compressions to the person, the hand position comes to determine the success rate of the CPR. The positioning of hands with the right amount of pressure and a constant appropriate rhythm of speed is necessary to execute it perfectly.

Improper hand position in CPR may decrease the effectiveness of chest compression. It can further worsen the situation leading to injury and organ damage. Hand placement in CPR plays a crucial role in increasing the possibility of survival.

The accurate hand position with the appropriate amount of pressure should be applied during the CPR process. The hand position and amount of pressure depend on the age of the person we are performing CPR on.

CPR Hand Placement for Adult

For providing CPR to the adult age group, we must consider the following things:

  • For Adult CPR, the hand position should be exactly in the center of the chest or slightly above the sternum.
  • You need to position the heel of one hand in the center of the chest and another heel of your hand directly on top by interlocking your fingers.
  • Then, position your shoulders directly over your hands by keeping your arms straight.
  • Now, you need to push straight down at least 2 inches deep at the rate of 100-120 compressions per minute.

After following these steps, allow the chest to fully rise, and avoid lifting your hand from the chest. Do not lean on the chest during the chest compressions. You should continue the process until the victim shows any sign of life or any professional help arrives.

CPR Hand Placement for Children and Infants

The purpose of CPR for children and infants is the same, but different techniques are used, such as hand placement, finger positioning, and the amount of pressure applied. The children and infants have a slightly delicate body as compared to adults. So, when performing CPR with correct hand placement for children and infants, we need to consider several things to ensure effective application of this first aid technique.

For children aged from 1 year to puberty:

  • Depending upon the age and size of the children, we can decide to either use single or both hands for chest compressions.
  • Place the heel of your hand just above the center of the chest or just above the sternum.
  • Position your shoulder directly over your hand, and keep your arm straight.
  • Push down at least 2 inches deep at the rate of at least 100-120 compressions per minute.
  • Use both hands if you get tired during compression and do not stop the process.

For children younger than 1 year old (Infants):

  • Be very careful. Use two fingers or 2 thumb encircling hands as alternatively for effective chest compression.
  • Place your fingers just below the nipple line.
  • Push down at least 1.5 inches deep at the rate of 100 compressions per minute, as an infant’s body size is relatively smaller to children.
  • As per the recommendation of AHA, mouth resuscitation is more important to infants and children. So, it is suggested to provide both of them in the correct ratio.
  • Continue the process until the breathing of the infant is normal or any professional help arrives.

Related Post: How Can You Achieve High Chest Compression Fraction

Differences of Hand Placement in CPR for Adults, Children, and Infants

Based on the age of the victim needing CPR the hand placement and amount of pressure slightly varies. There are different processes and approaches to hand placement in CPR for adults, children, and infants.

Hand placements in adult CPR usually involve the use of both hands because of their body size. However, the body sizes of children and infants are entirely different from that of adults, so the hand placement slightly differs for them. We use a single hand for children and 2 fingers for infants while performing the chest compressions. The hand should be placed just below the nipple line with a compression rate of at least 100 compressions per minute. The pressure should be applied slightly less to infants with a depth of 1.5 inches to their chest whereas you can apply the 2 inches of depth for children considering their age and body size.

Complications of Improper Hand Placement During CPR

Using correct hand placement during CPR may seem like a minor thing, but it greatly increases its effectiveness. Using incorrect hand positioning or applying too much pressure can lead to complications, such as rib fractures and injury to other vital organs.

Appropriate hand placement is essential for increasing the rate of survival. If the person applying for CPR has improper hand positioning, compression may not be deep enough to circulate blood through the body properly. Improper hand placement like placing the hands above the rib instead of the sternum leads to rib fractures and injuries. The internal organs could be affected by inadequate compression depth. Hence the effectiveness of CPR and the rate of survival are highly dependent on the hand placement in CPR.

Related Post: CPR Recovery Position

Summary

When you are in a cardiac emergency and CPR is the first intervention you are providing, you must be correctly placing your hand for optimal results. Consider the body size and age of the victim while providing CPR to ensure effective chest compression. If you are involved in CPR training then, you can have greater ideas to perform it accurately. If you want to be prepared for cardiac emergencies and perform CPR confidently, training and practice are crucial. Join Heart Start CPR and learn proper hand placement and effective chest compression techniques suited for different age groups and body sizes. Enroll now to be prepared for any emergency situation!

FAQs

What is sternum and its importance in hand placement?

The sternum is a flat bone located in the center of the chest also known as the breastbone that protects our vital organs like the heart and lungs. While performing CPR, placing your hands just above the sternum increases the effectiveness of CPR by optimizing blood circulation throughout the body and avoiding the risk of getting rib injuries.

How many hands should I use during CPR?

Depending on the victim’s age and the amount of pressure required, one should consider using either single or both hands. While performing CPR for adults, it is recommended to use both hands whereas for children it is recommended to use only one hand. For infants, you must only use your fingers to perform CPR as they have very fragile bones.

Why is mouth-to-mouth no longer recommended?

Hands-only CPR helps to sustain blood circulation more effectively during cardiac arrest than mouth-to-mouth resuscitation. It also interrupts the assisted flow of blood when including rescue breath while performing chest compression. So, stopping chest compression in order to perform mouth-to-mouth will interrupt the flow and may result greater risk.

When to stop CPR?

You should only stop performing CPR when the casualty shows signs of life like movement, coughing, or opening their eyes. Do not stop CPR until professional medical help arrives and takes over.

Where do you put the palm of your hand at the center of the chest?

You need to place the palm of your hand on the center of the chest, specifically on the lower half of the sternum (breastbone). For adults and children, use a one-hand placement by placing the heel of one hand in the center of the chest, with your fingers extended and not touching the chest. For infants, use a two-finger placement by placing your two fingers just below the nipple line, in the center of the chest. You need to make sure that your hands are positioned correctly to provide effective compressions without causing harm.

 

Author

LT. Jeff Haughy

Owner Jeff Haughy has been providing high-quality care in the EMS industry since 1995 and started his Fire Service career with the Alameda Fire Department in 1991 as a Fire Explorer.

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