Quality of Cardiopulmonary Resuscitation Performed Over Hockey Shoulder Pads: A Simulation Study

Purpose: Athletic trainers (ATs) must be prepared to manage cardiac arrest events in all athletes, including those participating in equipment-intensive sports. The goal of this study was to determine if first responders, specifically ATs, were able to perform high-quality cardiopulmonary resuscitation (CPR) over hockey shoulder pads. Methods: A sample of 50 ATs completed a one-minute, compression-only CPR proficiency test on a medium-fidelity manikin (Resusci Anne QCPR). Once deemed proficient, each participant completed CPR according to 2020 AHA guidelines on the manikin fitted with hockey shoulder pads for 8 minutes and 59 seconds. The primary measures of interest were the percentage of participants who achieved satisfactory performance on various aspects of CPR performance, namely overall CPR score, overall compression score, compression depth (mm), adequate compressions (%), compression rate (cpm), full chest recoil (%), and adequate ventilations (%). Results: In the presence of hockey shoulder pads, the mean proportion of chest compressions reaching adequate depth was only 51.82%. Additionally, the mean percentage of adequate ventilations was only 35.64% with 14% of participants not providing a single ventilation at an adequate volume. Overall CPR score, which includes both compressions and ventilations, was only 69.08% when performed over hockey pads. Conclusion: Our findings suggest ATs may struggle to provide quality chest compressions in the presence of hockey shoulder pads. Thus, results of this preliminary study indicate hockey pads should be removed prior to administering CPR.