High-quality chest compressions are critical for outcomes after pediatric cardiac arrest, yet rescuer ergonomics and bed height may adversely affect compression quality and fatigue. This randomized crossover simulation study will evaluate how four different bed-height settings influence pediatric CPR quality and rescuer biomechanics. Pediatric emergency medicine residents will perform 2-minute chest-compression-only CPR on a pediatric manikin placed on a hospital bed under four bed-height conditions in randomized order across separate sessions. CPR quality metrics from the manikin's feedback system, rescuer fatigue, physiologic responses, and arm angle over time will be compared to identify an ergonomically optimal bed-height approach.
Age ≥ 18 years
Pediatric resident/assistant physician working in the Department of Pediatrics (Akdeniz University) with valid ÇİYAD certification
Willing and able to provide written informed consent
Able to perform a 2-minute continuous chest-compression CPR cycle on a pediatric manikin
Known chronic cardiopulmonary disease that may limit physical exertion during CPR
Known musculoskeletal disorder or chronic condition that may affect CPR performance
Acute injury/illness at the time of participation that could impair safe CPR performance
Refusal or inability to provide informed consent
Crossover
Fixed Standard Bed Height (58 cm)
Other interventionHospital bed height is set to a fixed standard height of 58 cm for the CPR session.
Anthropometry-Based Bed Height (Patella Midpoint)
Other interventionHospital bed height is adjusted to the participant's patella midpoint reference before the CPR session.
Anthropometry-Based Bed Height (Lower One-Third Patella-ASIS)
Other interventionHospital bed height is adjusted to the lower one-third point of the distance between the patella and ASIS before the CPR session.
Self-Selected Bed Height
Other interventionParticipant selects the bed height they perceive as optimal/comfortable prior to the CPR session.
Correct chest compression depth (%, QCPR-defined)
Percentage of compressions meeting the target depth criteria as calculated by Laerdal Little Junior QCPR manikin sensors. (Recorded separately for each bed-height condition.)
Average chest compression depth (mm)
Mean compression depth (mm) recorded by the QCPR manikin.
Average chest compression rate (compressions/min)
Mean compression rate (compressions/min) recorded by the QCPR manikin.
Correct chest recoil / release (%, QCPR-defined)
ercentage of compressions with complete release (recoil) as calculated by the QCPR manikin.
Perceived exertion (Borg RPE score)
Borg scale score collected verbally at the end of each CPR cycle.
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