Abstract
This study was conducted to investigate the effect of resuscitation guideline terminology on the performance of infant cardiopulmonary resuscitation (CPR). A total of 40 intern or resident physicians conducted 2-min CPR with the two-finger technique (TFT) and two-thumb technique (TT) on a simulated infant cardiac arrest model with a 1-day interval. They were randomly assigned to Group A or B. The participants of Group A conducted CPR with the chest compression depth (CCD) target of "approximately 4 cm" and those of Group B conducted CPR with the CCD target of "at least one-third the anterior-posterior diameter of the chest". Single rescuer CPR was performed with a 15:2 compression to ventilation ratio on the floor. In both chest compression techniques, the average CCD of Group B was significantly deeper than that of Group A (TFT: 41.0 [range, 39.3-42.0] mm vs. 36.5 [34.0-37.9] mm, P = 0.002; TT: 42.0 [42.0-43.0] mm vs. 37.0 [35.3-38.0] mm, P < 0.001). Adequacy of CCD also showed similar results (Group B vs. A; TFT: 99% [82-100%] vs. 29% [12-58%], P = 0.001; TT: 100% [100-100%] vs. 28% [8-53%], P < 0.001). Using the CCD target of "at least one-third the anterior-posterior diameter of the chest" resulted in deep and adequate chest compressions during simulated infant CPR in contrast to the CCD target of "approximately 4 cm". Therefore, changes in the terminology used in the guidelines should be considered to improve the quality of CPR. Clinical Research Information Service; cris.nih.go.kr/cris/en (Registration number: KCT0003486).
Highlights
Adequate chest compression depth (CCD) is one of the key components for improving survival rate of out-of-hospital cardiac arrest [1,2,3]
Adequacy of CCD showed similar results (Group B vs. A; two-finger technique (TFT): 99% [82–100%] vs. 29% [12–58%], P = 0.001; thumb technique (TT): 100% [100–100%] vs. 28% [8–53%], P < 0.001)
Recommended CCD for adult cardiac arrest patients had been adjusted from “at least 5 cm” to “approximately 5 cm” in the 2015 international consensus of International Liaison Committee on Resuscitation because Stiell et al reported that maximum survival was expected in the depth interval from 40.3 to 55.3 mm [4,5,6]
Summary
A total of 40 intern or resident physicians conducted 2-min CPR with the two-finger technique (TFT) and two-thumb technique (TT) on a simulated infant cardiac arrest model with a 1-day interval. They were randomly assigned to Group A or B. The participants of Group A conducted CPR with the chest compression depth (CCD) target of “approximately 4 cm” and those of Group B conducted CPR with the CCD target of “at least one-third the anteriorposterior diameter of the chest”. Single rescuer CPR was performed with a 15:2 compression to ventilation ratio on the floor
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