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

Area of Science:

• Emergency Medicine
• Pediatric Resuscitation
• Cardiopulmonary Resuscitation

Background:

• Current pediatric basic life support (BLS) guidelines recommend a 1:5 ventilation-compression ratio, differing from the adult 2:15 ratio.
• This ratio is based on the premise that ventilation is more critical in pediatric resuscitation than in adult resuscitation.

Purpose of the Study:

• To test the hypothesis that a 2:15 ventilation-compression ratio could achieve equivalent minute ventilation to the 1:5 ratio in single-rescuer pediatric BLS.
• To evaluate the feasibility of simplifying CPR training for lay rescuers by standardizing the ventilation-compression ratio across age groups.

Main Methods:

• Fourteen lay rescuers were trained in single-rescuer BLS using both 1:5 and 2:15 ventilation-compression ratios.
• Rescuers performed BLS on a child-sized manikin with a respiratory monitor for approximately 4 minutes with each ratio in a randomized order.
• Chest compression quality (rate, depth, position) and ventilation effectiveness (tidal volume, minute ventilation) were assessed.

Main Results:

• No significant differences were observed in tidal volumes or minute ventilation between the 1:5 and 2:15 ratios during pediatric BLS.
• Chest compressions met acceptable depth and placement standards for both ratios.
• The mean number of chest compressions per minute was significantly higher (48% greater) with the 2:15 ratio compared to the 1:5 ratio.

Conclusions:

• The 2:15 ventilation-compression ratio provides comparable ventilation effectiveness to the 1:5 ratio in single-rescuer pediatric BLS.
• A standardized 2:15 ratio for both adult and pediatric BLS could simplify training for lay rescuers.
• This study supports the recommendation of a 2:15 ratio for all layperson BLS, regardless of age group.