Effectiveness of ventilation–compression ratios 1:5 and 2:15 in simulated single rescuer paediatric resuscitation

Abstract

Current guidelines for paediatric basic life support (BLS) recommend a ventilation–compression ratio of 1:5 during child resuscitation compared with 2:15 for adults, based on the consensus that ventilation is more important in paediatric than in adult BLS. We hypothesized that the ratio 2:15 would provide the same minute ventilation as 1:5 during single-rescuer paediatric BLS due to the reduced time required to change between ventilations and compressions. Fourteen lay rescuers were trained with both ratios and thereafter performed single rescuer BLS for ≈4 min with each of the two ratios in random order on a child-sized manikin with a built-in respiratory monitor. Quality of chest compressions was assessed by measurement of the rate, depth and position. There were no significant differences in tidal volumes or minute ventilation between the ratios. Nearly all chest compressions were within acceptable limits for depth and place with both methods, but the mean number of chest compressions per minute was 48±15% greater with ratio 2:15. In conclusion, there was no difference in ventilation, but nearly one and a half times as many compressions with a ratio of 2:15 than 1:5 for lay rescuers during single rescuer paediatric CPR. In order to simplify CPR training for laypersons, we recommend a 2:15 ratio for both single- and two-person, adult and paediatric layperson BLS.