From the Guidelines
The risk ratio of a CPR provider developing back pain is estimated to be higher than non-providers, with reports suggesting a significant incidence of back symptoms attributed to performing CPR. This increased risk is primarily due to the biomechanical stress placed on the spine during chest compressions, as noted in a prospective observational study (LOE 4) that described 5 musculoskeletal injuries (4 back-related) associated with performing chest compressions in 1265 medical emergency team (MET) call participants 1. The repetitive motion of leaning forward while applying significant downward force creates substantial strain on the lower back muscles and intervertebral discs. Key factors that contribute to this risk include:
- Poor body mechanics during chest compressions
- Extended periods of performing CPR
- Failure to rotate compressors regularly to prevent fatigue
- Inadequate adjustment of the patient surface height
- Lack of regular back-strengthening exercises
To mitigate this risk, CPR providers should:
- Maintain proper positioning with straight arms and shoulders aligned over the hands
- Utilize mechanical compression devices when available for prolonged resuscitations
- Rotate compressors every 2 minutes to prevent fatigue
- Adjust the height of the patient surface when possible
- Engage in regular back-strengthening exercises, as suggested by the findings of a simulation study (LOE 5) that showed increased rescuer oxygen consumption during chest compressions 1.
From the Research
Risk Ratio of CPR Providers Developing Back Pain
- The risk ratio of a Cardiopulmonary Resuscitation (CPR) provider developing back pain is not directly addressed in the provided studies, but some studies provide relevant information on the topic.
- A study published in 2004 2 found that over 80% of nurses experienced back discomfort during or after performing CPR, and 56% considered their back discomfort to be related to the duration of the procedure.
- The same study found that 20% of the nurses suffered back injury or prolapsed disc, and over 40% of these "injured" nurses considered their back injury to be related to or aggravated by CPR.
- Another study published in 2014 3 focused on the clinical prediction rule for identifying patients with low back pain who are likely to experience short-term success following lumbar stabilization exercises, but it does not provide information on the risk ratio of CPR providers developing back pain.
- Studies published in 2002 4, 2016 5, and 2013 6 do not provide relevant information on the risk ratio of CPR providers developing back pain.
- Based on the available evidence, it can be inferred that performing CPR may pose a risk of back discomfort or injury to the provider, but the exact risk ratio is not quantified in the provided studies.