Quantitative assessment of chest compression techniques on an infant manikin.

Abstract

Current cardiopulmonary resuscitation (CPR) guidelines recommend the two-finger technique (TFT) of chest compression (CC) in infants for a single rescuer. We hypothesized that healthcare providers cannot achieve adequate CC depth with TFT, even if using real-time visual feedback (RVF). This was a cross-over study, randomizing participants to perform three sets of 2-min continuous CC, comparing (i) TFT with RVF, (ii) the one-hand technique (OHT) without RVF, and (iii) OHT with RVF. A standard CPR trainer manikin of a 3-month-old infant and a monitor/defibrillator that displays and records the quantitative CC quality were used. We set a target compression depth of 40-50 mm and a target compression rate of 100-120/min. Data were analyzed using the Friedman test and Bonferroni correction. Statistical significance was defined as P-value of< 0.05. Fifty-nine healthcare providers participated in the study. The mean compression depth was 24 mm (interquartile range [IQR], 22-26 mm) in TFT with RVF and 43 mm (IQR, 38-48 mm) in OHT without RVF, P < 0.001. The proportion of adequate CC depth was 0% (IQR, 0-0%) in TFT with RVF, 22% (IQR, 5-54%) in OHT without RVF, and 62% (IQR, 29-83%) in OHT with RVF. The mean compression rate was within the target range in all three techniques. The TFT cannot produce the CC depth that meets the recommendation of the current CPR guidelines for an infant with RVF, whereas the OHT does.