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In Reply: Mr Rottenberg discusses an important issue regarding the likelihood of delivering chest compressions forceful enough to press the sternum 38 mm to 51 mm. The rescuer’s physical strength and endurance will be limiting factors, together with the team members’ understanding of how and when to change the person providing compression. How to improve this performance has not been established. One method may be to follow Mr Rottenberg’s suggestion that the rescuer should be no smaller than the patient. Other methods may be to change the responder performing compression every 1 to 2 minutes, to introduce prompts according to the quality of chest compressions delivered, or to perform mechanical chest compressions. Our research group is currently investigating the use of these methods to increase the quality of chest compressions.

Lars Wik, MD, PhD
lars.wik@medisin.uio.no
Institute for Experimental Medical Research
Ulleval University Hospital
Oslo, Norway

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293:2090-2091.

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