An interventional study of Interlocked-finger chest compression technique and Overlapped hands chest compression technique in Cardiac Arrest (CA), sponsored by University of Pecs. Recruiting at 1 site in Hungary. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-09-21.
Sponsored by University of Pecs · Not applicable, Interventional, and Treatment
This randomized crossover simulation study will compare two hand positions used during chest compressions: interlocked fingers and non-interlocked hands placed one on top of the other. The study will evaluate whether the non-interlocked hand position is non-inferior to the interlocked-finger technique with regard to chest compression depth, and will compare the two techniques in terms of CPR quality, rescuer comfort, fatigue, pain or discomfort, and perceived hand-position stability.
High-quality chest compressions are a key component of cardiopulmonary resuscitation (CPR). Current international resuscitation guidelines recommend placing one hand on top of the other during chest compressions, but recommendations regarding whether the fingers should be interlocked or simply placed on top of each other are based on limited scientific evidence.
This prospective, randomized, controlled crossover simulation study will compare two hand positions during continuous chest compressions on an adult CPR manikin. Each participant will perform two 2-minute chest compression periods, using both techniques in a computer-randomized order: (1) interlocked fingers, representing the commonly taught technique, and (2) non-interlocked hands placed one on top of the other. A 10-minute seated rest period will separate the two measurement periods.
The primary outcome will be mean chest compression depth. Secondary outcomes will include compression rate, proportion of compressions with adequate depth and full chest recoil, temporal changes in compression depth, and subjective assessments of pain, discomfort, physical fatigue, hand-position stability, and confidence in performing chest compressions. Participants will also indicate which technique they would prefer in a real resuscitation situation.
The study will be conducted in a simulation environment at the Human Patient Simulation Center of the University of Pécs Faculty of Health Sciences. Participants will not receive real-time feedback from the manikin during the measurements.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants will perform continuous chest compressions using the interlocked-finger hand position. One hand will be placed on the lower half of the sternum, with the other hand placed on top and the fingers interlocked. Chest compressions will be performed for 2 minutes according to current international CPR recommendations, targeting a compression depth of 5-6 cm, a rate of 100-120 compressions per minute, and complete chest recoil after each compression. No real-time feedback from the manikin will be provided during the measurement.
Behavioral: Interlocked-finger chest compression technique
Participants will perform continuous chest compressions using the non-interlocked hand position. One hand will be placed on the lower half of the sternum, with the other hand placed directly on top without interlocking the fingers. Finger contact between the two hands will be permitted, but active interlocking will not be performed. Chest compressions will be performed for 2 minutes under the same conditions as the interlocked-finger condition, targeting a compression depth of 5-6 cm, a rate of 100-120 compressions per minute, and complete chest recoil after each compression. No real-time feedback from the manikin will be provided during the measurement.
Behavioral: Overlapped hands chest compression technique
Participants will perform chest compressions using the interlocked-finger hand position. One hand will be placed on the lower half of the sternum and the other hand on top, with the fingers interlocked. The intervention will consist of 2 minutes of continuous chest compressions performed at a target rate of 100-120 compressions per minute and a target depth of 5-6 cm, with complete chest recoil after each compression. No real-time feedback will be provided.
Participants will perform chest compressions using the non-interlocked hand position. One hand will be placed on the lower half of the sternum and the other hand on top without interlocking the fingers. The intervention will consist of 2 minutes of continuous chest compressions performed under the same conditions as the interlocked-finger technique, with a target rate of 100-120 compressions per minute, a target depth of 5-6 cm, and complete chest recoil after each compression. No real-time feedback will be provided.
Mean chest compression depth (mm)
Mean chest compression depth recorded continuously by the manikin's integrated measurement system during CPR performance.
Time frame: During procedure.
Chest compression rate (per minute)
Mean chest compression rate (compressions per minute) recorded by the manikin's integrated measurement system during CPR performance.
Time frame: During procedure.
Proportion of compressions with adequate depth (%)
Proportion of chest compressions meeting the predefined target depth, as recorded by the manikin's integrated measurement system.
Time frame: During procedure.
Proportion of compressions with complete chest recoil (%)
Proportion of chest compressions followed by complete chest recoil, as recorded by the manikin's integrated measurement system.
Time frame: During procedure.
Interruption duration (sec)
Duration of interruptions in chest compressions (hand-off time), if applicable, recorded by the manikin's integrated measurement system.
Time frame: During procedure.
Overall chest compression quality score (points, mean, SD)
Overall chest compression quality score calculated by the manikin's integrated measurement system based on predefined CPR performance parameters.
Time frame: During procedure.
Self-reported hand pain
Participants' self-reported overall hand pain following CPR performance, assessed using a 0-10 Numeric Rating Scale, where 0 indicates no pain and 10 indicates the worst imaginable pain.
Time frame: Immediately after the CPR procedure (within 15 minutes)
Finger discomfort
Participants' self-reported discomfort in the fingers following CPR performance, assessed using a 0-10 Numeric Rating Scale.
Time frame: Immediately after the CPR procedure (within 15 minutes)
Wrist discomfort
Participants' self-reported wrist discomfort following CPR performance, assessed using a 0-10 Numeric Rating Scale.
Time frame: Immediately after the CPR procedure (within 15 minutes)
Perceived physical fatigue
Participants' self-reported physical fatigue following CPR performance, assessed using a 0-10 Numeric Rating Scale.
Time frame: Immediately after the CPR procedure (within 15 minutes)
Perceived hand-position stability
Participants' perceived stability of their hand position during CPR performance, assessed using a 0-10 Numeric Rating Scale.
Time frame: Immediately after the CPR procedure (within 15 minutes)
Perceived hand slippage
Participants' perceived sensation of hand slippage during CPR performance, assessed using a 0-10 Numeric Rating Scale.
Time frame: Immediately after the CPR procedure (within 15 minutes)
Preferred hand position
Participants' preferred hand position for performing CPR in a real-life cardiac arrest situation.
Time frame: Immediately after the CPR procedure (within 15 minutes)
Plan to share: Yes — De-identified individual participant data underlying the results reported in publications arising from this study may be made available to qualified researchers upon reasonable request. The shared data may include participant-level demographic characteristics and de-identified CPR performance and subjective outcome data collected during the study.
Supporting information: Study protocol, Statistical analysis plan, Informed consent form
Time frame: Beginning upon publication of the primary results of the study and with no planned end date.
Access criteria: Data may be requested from the corresponding author for scientifically justified research purposes. Requests will be reviewed by the research team and will be considered subject to applicable ethical, legal, and data protection requirements. Data may only be shared in a de-identified form and subject to appropriate conditions for data use.
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