Comparison between modified and conventional one-handed chest compression techniques for child cardiopulmonary resuscitation: A randomised, non-blind, cross-over simulation trial.

Abstract

Chest compression depth (CCD) decreases significantly when performing one-handed chest compression (OHCC). We modified OHCC posture to increase CCD as follows: first, the axis of the compression hand was adjusted to the compression area; second, the opposite hand was wrapped around the elbow of the compression arm. This study compared modified OHCC with conventional OHCC for child cardiopulmonary resuscitation. A total of 46 health-care providers performed 2 min of continuous chest compression using conventional OHCC (trial 1) and modified OHCC (trial 2) in a random order on a 5-year-old-sized child manikin lying on a bed. Chest compression parameters were assessed with an accelerometer and analysed by comparing the mean values of 30-s segments. The average CCD decreased significantly in all segments in both trials (trial 1 (segments 1-4): 40.9 ± 5.6 mm, 39.4 ± 6.6 mm, 38.0 ± 6.9 mm, 36.7 ± 7.3 mm, P < 0.001; trial 2 (segments 1-4): 42.3 ± 5.4 mm, 41.2 ± 6.2 mm, 40.1 ± 6.8 mm, 39.0 ± 6.9 mm, P < 0.001). However, the average CCD in trial 2 was significantly greater in all segments than that in trial 1 (segments 1-4: P = 0.016; P = 0.009; P = 0.004; P = 0.001). The average chest compression rates were comparable in all segments in both trials. By modifying OHCC posture, a deeper mean CCD could be maintained for 2 min than by using conventional OHCC.