The purpose of this study is to consider the perceptions of rescuers of ACD operation and their anatomy characteristics are evaluated to yield a better understanding on operation of ACD. A prospective, descriptive study to evaluate professional providers received ACD training. A total of 39 emergency medical professional participated in this study. CPR is performed as both ACD and standard CPR on a manikin separately. 56.4% of the participants felt that the ACD device was not easy or was very difficult to use. The easy-to-use group had a greater height, shoulder to iliac crest distance, shoulder to knee distance, and forearm length. The taller rescuers operate ACD more easily. In addition, women might operate ACD more difficultly. Modifying the operation of ACD (such as by putting a blanket put under the rescuer's knee or using footstool) was recommended and seems reasonable. These issues should be addressed on training.