Literature DB >> 20227156

Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR.

Sharda Udassi1, Jai P Udassi, Melissa A Lamb, Douglas W Theriaque, Jonathan J Shuster, Arno L Zaritsky, Ikram U Haque.   

Abstract

OBJECTIVE: Infant CPR guidelines recommend two-finger chest compression with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. We hypothesized that lone rescuer two-thumb CPR is associated with increased ventilation cycle time, decreased ventilation quality and fewer chest compressions compared to two-finger CPR in an infant manikin model.
DESIGN: Crossover observational study randomizing 34 healthcare providers to perform 2 min CPR at a compression rate of 100 min(-1) using a 30:2 compression:ventilation ratio comparing two-thumb vs. two-finger techniques.
METHODS: A Laerdal Baby ALS Trainer manikin was modified to digitally record compression rate, compression depth and compression pressure and ventilation cycle time (two mouth-to-mouth breaths). Manikin chest rise with breaths was video recorded and later reviewed by two blinded CPR instructors for percent effective breaths. Data (mean+/-SD) were analyzed using a two-tailed paired t-test. Significance was defined qualitatively as p< or =0.05. RESULT: Mean % effective breaths were 90+/-18.6% in two-thumb and 88.9+/-21.1% in two-finger, p=0.65. Mean time (s) to deliver two mouth-to-mouth breaths was 7.6+/-1.6 in two-thumb and 7.0+/-1.5 in two-finger, p<0.0001. Mean delivered compressions per minute were 87+/-11 in two-thumb and 92+/-12 in two-finger, p=0.0005. Two-thumb resulted in significantly higher compression depth and compression pressure compared to the two-finger technique.
CONCLUSION: Healthcare providers required 0.6s longer time to deliver two breaths during two-thumb lone rescuer infant CPR, but there was no significant difference in percent effective breaths delivered between the two techniques. Two-thumb CPR had 4 fewer delivered compressions per minute, which may be offset by far more effective compression depth and compression pressure compared to two-finger technique. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

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Year:  2010        PMID: 20227156     DOI: 10.1016/j.resuscitation.2009.12.029

Source DB:  PubMed          Journal:  Resuscitation        ISSN: 0300-9572            Impact factor:   5.262


  14 in total

1.  Singapore Neonatal Resuscitation Guidelines 2016.

Authors:  Cheo Lian Yeo; Agnihotri Biswas; Teong Tai Kenny Ee; Amutha Chinnadurai; Vijayendra Ranjan Baral; Alvin Shang Ming Chang; Imelda Lustestica Ereno; Kah Ying Selina Ho; Woei Bing Poon; Varsha Atul Shah; Bin Huey Quek
Journal:  Singapore Med J       Date:  2017-07       Impact factor: 1.858

2.  Comparison of two infant chest compression techniques during simulated newborn cardiopulmonary resuscitation performed by a single rescuer: A randomized, crossover multicenter trial.

Authors:  Jacek Smereka; Marcin Madziala; Lukasz Szarpak
Journal:  Cardiol J       Date:  2018-08-29       Impact factor: 2.737

3.  A Comparison between Three Different Techniques Considering Quality Skills, Fatigue and Hand Pain during a Prolonged Infant Resuscitation: A Cross-Over Study with Lifeguards.

Authors:  Roberto Barcala-Furelos; Martín Barcala-Furelos; Francisco Cano-Noguera; Martín Otero-Agra; Alejandra Alonso-Calvete; Santiago Martínez-Isasi; Silvia Aranda-García; Sergio López-García; Antonio Rodríguez-Núñez
Journal:  Children (Basel)       Date:  2022-06-17

4.  Which Fingers Should We Perform Two-Finger Chest Compression Technique with When Performing Cardiopulmonary Resuscitation on an Infant in Cardiac Arrest?

Authors:  Young Sinn Kim; Je Hyeok Oh; Chan Woong Kim; Sung Eun Kim; Dong Hoon Lee; Jun Young Hong
Journal:  J Korean Med Sci       Date:  2016-04-12       Impact factor: 2.153

5.  Evaluation of a newly developed infant chest compression technique: A randomized crossover manikin trial.

Authors:  Jacek Smereka; Karol Bielski; Jerzy R Ladny; Kurt Ruetzler; Lukasz Szarpak
Journal:  Medicine (Baltimore)       Date:  2017-04       Impact factor: 1.889

6.  Comparison of two-thumb encircling and two-finger technique during infant cardiopulmonary resuscitation with single rescuer in simulation studies: A systematic review and meta-analysis.

Authors:  Ji Eun Lee; Juncheol Lee; Jaehoon Oh; Chan Hyuk Park; Hyunggoo Kang; Tae Ho Lim; Kyung Hun Yoo
Journal:  Medicine (Baltimore)       Date:  2019-11       Impact factor: 1.817

7.  Dominant versus non-dominant hand during simulated infant CPR using the two-finger technique: a randomised study.

Authors:  Debora Gugelmin-Almeida; Carol Clark; Ursula Rolfe; Michael Jones; Jonathan Williams
Journal:  Resusc Plus       Date:  2021-05-27

Review 8.  [Newborn resuscitation and support of transition of infants at birth].

Authors:  John Madar; Charles C Roehr; Sean Ainsworth; Hege Ersda; Colin Morley; Mario Rüdiger; Christiane Skåre; Tomasz Szczapa; Arjan Te Pas; Daniele Trevisanuto; Berndt Urlesberger; Dominic Wilkinson; Jonathan P Wyllie
Journal:  Notf Rett Med       Date:  2021-06-02       Impact factor: 0.892

9.  Rescuer Exertion and Fatigue Using Two-Thumb vs. Two-Finger Method During Simulated Neonatal Cardiopulmonary Resuscitation.

Authors:  Claire Reynolds; Jennifer Cox; Vicki Livingstone; Eugene Michael Dempsey
Journal:  Front Pediatr       Date:  2020-04-02       Impact factor: 3.418

10.  Differences in the performance of resuscitation according to the resuscitation guideline terminology during infant cardiopulmonary resuscitation: "Approximately 4 cm" versus "at least one-third the anterior-posterior diameter of the chest".

Authors:  Wongyu Lee; Dongjun Yang; Je Hyeok Oh
Journal:  PLoS One       Date:  2020-03-24       Impact factor: 3.240

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