CPR for children: one hand or two?

Area of Science:

• Emergency Medicine
• Cardiopulmonary Resuscitation (CPR)
• Pediatric Resuscitation

Background:

• Current CPR guidelines recommend one-handed compressions for children (1-8 years) and two-handed for adults (>8 years).
• Previous research has not compared the intrathoracic compression pressures generated by these two techniques.

Purpose of the Study:

• To assess the difference in intrathoracic compression pressures between one-handed and two-handed chest compression techniques in a pediatric manikin.
• To evaluate the ease of performance for each technique on a pediatric manikin.

Main Methods:

• A randomized crossover design was employed.
• Thirty volunteer subjects performed both one-handed and two-handed chest compressions on an adapted pediatric resuscitation manikin.
• Compression pressures were recorded using a pressure transducer connected to a personal computer.

Main Results:

• The two-handed technique yielded a significantly higher mean compression pressure (86.6 mmHg) than the one-handed technique (75.1 mmHg) (P < 0.001).
• Average peak compression pressure was also significantly higher with the two-handed technique (133.5 mmHg) versus the one-handed technique (116.8 mmHg) (P = 0.001).
• Twenty-nine out of thirty participants found the two-handed technique easier to perform.

Conclusions:

• The two-handed chest compression technique appears easier to perform and generates higher pressures on a pediatric resuscitation manikin.
• Further research is necessary to determine the clinical effectiveness of each technique in actual pediatric patients and their impact on outcomes.