Buoyancy‐assisted versus conventional drain‐then‐lift methods for bathtub extrication: A randomized crossover simulation study

Abstract Background Effective cardiopulmonary resuscitation (CPR) for bathtub cardiac arrest is often delayed due to the challenges associated with patient extrication. Objectives In this study, we evaluated a practical buoyancy‐assisted extrication method for lay rescuers to facilitate rapid CPR initiation. Methods Fifty‐four university students participated in this simulation. A human model (170.0 cm, 78.0 kg) was placed in a bathtub filled with 180 L of water. Participants were randomly assigned to two sequences: Group A (conventional‐then‐buoyancy) and Group B (buoyancy‐then‐conventional). The conventional method involved draining the water before lifting, whereas the buoyancy‐assisted method utilized water displacement to ease lifting. Success rates were analyzed using chi‐squared tests and odds ratios, whereas extrication times were compared using paired t ‐tests. Results With the conventional method, success was significantly associated with the rescuer's sex ( p < 0.0001), height ( p < 0.0028), and weight ( p < 0.0001). However, no such associations were observed with the buoyancy method. The buoyancy method achieved a significantly higher success rate than the conventional method (98.1% vs. 81.5%; OR: 12.0; 95% confidence interval: 1.5–97.8; and p < 0.008) and a shorter extrication time (mean: 24.7 vs. 47.9 s and p < 0.0001). No adverse events occurred. Postexercise, 53 of 54 participants favored the buoyancy method for future use. Conclusions Buoyancy‐assisted extrication is faster and more reliable than the conventional drain‐then‐lift approach, regardless of the rescuer's physique. This method may facilitate earlier CPR initiation in bathtub‐related cardiac arrest situations.