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It is difficult enough trying to estimate a chest compression depth of 4–5 cm when patients are lying on a firm surface, but it is even more tricky when they are lying on a mattress. Noordegraaf et al measured hand movement during chest compression on a manikin lying on a mattress. They discovered that rescuers needed to move their hands downwards for as much as 11 cm in order to achieve a chest compression depth of 4–5 cm. Use of a backboard reduced the required additional compression of the mattress by about 50%. The additional motion and increased workload adds extra complexity to cardiopulmonary resuscitation—this needs to be taken into account during training (Resuscitation 2009;80:546–52).


Emergency Departments are proving to be as popular as ever, all over the world. So much so in fact, that ED overcrowding has become a global problem. A group from Chicago evaluated ED congestion by means of a computer simulation model. They showed that improving the …

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