Objectives:  This prospective observational study was performed to investigate if the hand position used for external chest compressions is in an optimal position for compressing the ventricles during standard cardiopulmonary resuscitation (CPR).Methods:  Transesophageal echocardiography (TEE) was performed during standard CPR in 34 patients with nontraumatic cardiac arrest (24 males, mean ± standard deviation [SD] age = 56 ± 12 years). On the recorded image of TEE, an area of maximal compression (AMC) was identified, and the degree of compression at the AMC and the left ventricular stroke volume was calculated.Results:  A significant narrowing of the left ventricular outflow tract (LVOT) or the aorta was noted in all patients, with the degree of compression at the AMC ranging from 19% to 83% (mean ± SD = 49 ± 19%). The AMC was found at the aorta in 20 patients (59%) and at the LVOT in 14 patients (41%). A significant narrowing of more than 50% of the diameter at the end of the relaxation phase occurred in 15 patients (44%). On linear regression, the left ventricular stroke volume was correlated with the location of the AMC (R² = 0.165, p = 0.017).Conclusions:  The outflow of the left ventricle is affected during standard CPR, resulting in varying degrees of narrowing in the LVOT and/or the aortic root.

To examine the relationship between stress, social support, and empathy among medical students.

Previous studies on empathy in Korean medical students were conducted on small populations or with different scales of measurement, resulting in low representativeness and generalisability of the findings. To evaluate empathy in Korean medical students throughout the country and to make suggestions to improve empathy. The Jefferson Scale of Empathy (JSE) (Korean) was used, and the impact of sex, age, the medical school admission system, and grade of the respondents was investigated. We analyzed 5343 questionnaires and found a mean empathy score of 105.9 ± 12.8. Females and post-baccalaureate students had higher scores as compared with their counterparts. There was a significant difference between the admission systems after controlling for gender. Students from higher grade levels had lower scores than those from the lower grade levels. The JSE score of Korean medical students was lower than that of students in Western countries. The difference of gender and medical school admission system should be considered, and capability to apply empathy to clinical practice should be focused upon in medical training.