To the Editor,
We read with great interest an article by Ott et al. [1] who bring up the topic of compression of the chest to the legs and heels as an alternative for medical professionals in the times of COVID-19 due to the increased distance from the patient's airway and the limitation of contact from the infectious aerosol. Unfortunately, in our opinion, the alternative method provided by the authors has many limitations regarding its widespread use. One of them is a potential balance problem for people performing these types of chest compressions, which can lead to breakage of chest compressions, the consequences of which can be dramatic for both the patient and the medical staff, who may be injured during a fall. Also, the PPE it holds can break and expose it potentially more than conventional compression methods. Also, the control of the strength and depth of compressions, especially without long-term training of medical personnel in this type of techniques, may lead to their ineffectiveness and may be too shallow or too strong, which may lead to very serious damage not only to the ribs and sternum, but also to internal organs. People who perform such compressions may also be at risk of missing the correct compression site more frequently and further injure the patient. We should also consider whether such methods make sense to use among medical personnel who are constantly exposed to the aerosol with pathogens in COVID-19 wards and the distance during compression will not make it absent from the medical staff. Remember that the conditions performed during the simulation are not the same as in hospitals, and in case of sudden cardiac arrest, the use of this method may be impossible or very difficult in many cases.
Conflict of interest disclosures
The other authors have no example conflicts of interest to disclose.
Funding/support
No funding was secured for this study.
Role of funder/sponsor
None.
Clinical trial registration
Not applicable.
References
- 1.Ott M., Krohn A., Bilfield L.H., et al. Leg-heel chest compression as an alternative for medical professionals in times of COVID-19. Am J Emerg Med. 2021 doi: 10.1016/j.ajem.2021.09.007. ISSN 0735-6757. [DOI] [PMC free article] [PubMed] [Google Scholar]