Two-thumb-encircling advantageous for lay responder infant CPR: a randomised manikin study. Issue 6 (14th July 2018)

• Record Type: Journal Article
• Authors: Pellegrino, Jeffrey L; Bogumil, David; Epstein, Jonathan L; Burke, Rita V
• Is Part Of: Archives of disease in childhood. Volume 104:Issue 6(2019)
• Page Start: 530
• Page End: 534
• Publication Date: 2018-07-14
• Subjects: comm child health -- measurement -- medical education -- resuscitation; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2018-314893
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Objective: Paediatric health providers and educators influence infant mortality through advocacy and training within families and communities. This research sought to establish the efficacy and training of two-finger versus two-thumb-encircling techniques for lone responder infant chest compressions with ventilations in initially trained infant caregivers. Design: This is a randomised, cross-over educational intervention assessed on instrumented manikins using the 2015 guideline measures of quality infant cardiopulmonary resuscitation (CPR). Additional subjective data on the experience were collected through self-reporting. Setting: Non-healthcare community organisations and secondary school classrooms. Participants: Fourteen years or older, fluent in English and had not taken infant CPR in the last 5 years. Interventions: Groups of eight participants were randomised to learn one technique, practised and then tested for 8 min. After a 30 min rest, the group repeated the process using the other technique. Main outcome measures: Mean chest compression depth and rate, compression fraction, and correct hand position; tiredness and pain as reported by the caregiver. Results: The two-thumb-encircling technique achieved a deeper mean compression depth over the 8 min period (2.0 mm, p<0.01), closer to the minimum recommendation of 40 mm; the two-finger technique achieved higher percentages of compression fraction and complete recoil. Caregivers preferred the two-thumb technique (64%), and of these 70% had long fingernails. Conclusions: The two-thumb-encircling technique improved compression depth, over an 8 min scenario, and was preferred by caregivers. This adds to the existing literature on the advantages of two-thumb-encircling as a technique for lone and team infant CPR, which counters current guidelines.