Hye Young Jang1, Heather Wolfe2, Ting-Chang Hsieh3, Mary Kate Abbadessa4, Sage Myers4, Vinay Nadkarni5, Aaron Donoghue6. 1. Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea. 2. Division of Critical Care Medicine, Children's Hospital of Philadelphia, PA, United States. 3. Department of Pediatrics, Children's Hospital of Philadelphia, PA, United States. 4. Division of Pediatric Emergency Medicine, Children's Hospital of Philadelphia, PA, United States. 5. Division of Critical Care Medicine, Children's Hospital of Philadelphia, PA, United States; Center for Simulation, Advanced Education and Innovation, Children's Hospital of Philadelphia, PA, United States. 6. Division of Critical Care Medicine, Children's Hospital of Philadelphia, PA, United States; Division of Pediatric Emergency Medicine, Children's Hospital of Philadelphia, PA, United States; Center for Simulation, Advanced Education and Innovation, Children's Hospital of Philadelphia, PA, United States. Electronic address: donoghue@email.chop.edu.
Abstract
AIM: To use video review to compare CC quality between 2-thumb encircling (2T) and one-hand anterior (1H) hand position in infants receiving CPR. METHODS: Events where an infant received >2min of CC using a CPR monitor device while videorecorded were included. CC were measured in segments provided by a single compressor; segment duration, identity of the compressor, and hand position (2T vs 1H) was determined from video review. CC rate and depth were measured by the monitor device. RESULTS: Seven infants received 111min of CCs from a total of 28 providers. 12/28 providers were assessed using both 2T and 1H; 6 providers used 2T and 1H in the same patient. 80 CC segments were analyzed; the median duration of CC segments was 74s (IQR 50-95s). Median CC rate across all segments was 127/min (IQR 115-142/min); median CC depth was 3.0cm (IQR 2.4-3.4cm). 2T position was used in 33/80 (41%) of segments. There was no significant difference in CC depth between 2T and 1H position (3.0±0.8 vs 3.0±0.6cm, p=0.81). 1H position was significantly associated with faster CC rate than 2T position (134±18 vs. 118±15 CC/min, p<0.001). CONCLUSIONS: During CC in infants, 1H position was associated with a greater prevalence of inappropriately fast CC rate compared to 2T. There was no significant difference in depth between 2T and 1H. Future studies should evaluate the effect of hand position on clinical outcomes.
AIM: To use video review to compare CC quality between 2-thumb encircling (2T) and one-hand anterior (1H) hand position in infants receiving CPR. METHODS: Events where an infant received >2min of CC using a CPR monitor device while videorecorded were included. CC were measured in segments provided by a single compressor; segment duration, identity of the compressor, and hand position (2T vs 1H) was determined from video review. CC rate and depth were measured by the monitor device. RESULTS: Seven infants received 111min of CCs from a total of 28 providers. 12/28 providers were assessed using both 2T and 1H; 6 providers used 2T and 1H in the same patient. 80 CC segments were analyzed; the median duration of CC segments was 74s (IQR 50-95s). Median CC rate across all segments was 127/min (IQR 115-142/min); median CC depth was 3.0cm (IQR 2.4-3.4cm). 2T position was used in 33/80 (41%) of segments. There was no significant difference in CC depth between 2T and 1H position (3.0±0.8 vs 3.0±0.6cm, p=0.81). 1H position was significantly associated with faster CC rate than 2T position (134±18 vs. 118±15 CC/min, p<0.001). CONCLUSIONS: During CC in infants, 1H position was associated with a greater prevalence of inappropriately fast CC rate compared to 2T. There was no significant difference in depth between 2T and 1H. Future studies should evaluate the effect of hand position on clinical outcomes.
Authors: Aaron Donoghue; Debra Heard; Russell Griffin; Mary Kate Abbadessa; Shannon Gaines; Sangmo Je; Richard Hanna; John Erbayri; Sage Myers; Dana Niles; Vinay Nadkarni Journal: Resusc Plus Date: 2021-04-10