Introduction: Sudden cardiac arrest represents a major public health concern, with survival largely dependent on the timely and high-quality delivery of basic life support. In specific environments, such as winter and mountainous settings, cardiopulmonary resuscitation (CPR) is often performed while wearing protective equipment, including ski mittens, which may affect the quality of chest compressions. However, the impact of such equipment on chest compression performance remains insufficiently investigated. Purpose: The aim of this master's thesis was to investigate the effect of wearing ski mittens on the quality of chest compressions during basic life support and on participants’ subjective perceptions of performance. Methods: In a randomized crossover experimental study, 52 healthcare students performed chest compressions on a manikin under two conditions: while wearing ski mittens and without mittens. The magnitude and direction of the forces applied during chest compressions were measured using a Kistler force plate and a Resusci Anne manikin (Laerdal, Norway) for the assessment of CPR quality. Subjective experience, including perceived difficulty, fatigue, discomfort, stability, and manual control, was evaluated using a structured questionnaire. Results: Chest compression depth (69 ± 9 vs. 70 ± 7 mm; p > 0.05), compression rate (117 ± 16 vs. 118 ± 15 compressions/min; p > 0.05), and overall CPR quality score (95% vs. 94%; p = 0.27) did not differ significantly between the mitten and no-mitten conditions. Complete chest recoil was significantly better when participants wore mittens (98% vs. 86%; p = 0.002). Peak compression force was slightly lower with mittens than without (632 ± 164 N vs. 648 ± 164 N; p = 0.01); however, the effect size was negligible (Cliff’s δ = 0.08). The mean deviation of peak force from the vertical axis showed no significant difference between conditions (4.7° ± 2.4° in both cases; p = 0.86). Participants reported greater perceived difficulty, discomfort, fatigue, reduced stability, and poorer manual control while wearing mittens (all p < 0.05). Discussion and conclusion: Wearing ski mittens did not significantly impair the objective quality of chest compressions; however, it increased perceived exertion and discomfort among rescuers. Therefore, basic life support training programs intended for cold-weather environments should incorporate practice while wearing gloves or mittens to improve rescuer preparedness while ensuring adequate hand protection from low temperatures. Future research should investigate different types of protective gloves and evaluate CPR performance under real winter conditions.
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