The two-thumb technique using an elevated surface is preferable for teaching infant cardiopulmonary resuscitation

Area of Science:

• Pediatric Emergency Medicine
• Cardiopulmonary Resuscitation Techniques
• Neonatal Resuscitation

Background:

• Effective chest compressions are critical for infant cardiopulmonary resuscitation (CPR).
• The optimal technique and surface for administering infant CPR remain areas of investigation.
• Standardization of CPR techniques can improve patient outcomes.

Purpose of the Study:

• To compare the efficacy of the two-thumb versus the two-finger technique for chest compressions in infant CPR.
• To evaluate the impact of different surfaces (floor, table, radiant warmer) on CPR effectiveness.
• To determine provider preference and perceived exertion for different CPR surfaces.

Main Methods:

• Twenty medical personnel trained in Neonatal Resuscitation Program performed CPR on a manikin.
• The two-thumb and two-finger techniques were used with a 30:2 compression-to-ventilation ratio for 2 minutes.
• Compressions were administered on the floor, a table, and a radiant warmer in random order.

Main Results:

• The two-thumb technique resulted in significantly greater compression depth compared to the two-finger technique across all surfaces (P < .05).
• The two-thumb technique demonstrated less variability and less compression decay over time than the two-finger technique.
• Providers found the table surface most comfortable and least tiring, while the floor was least preferred.

Conclusions:

• The two-thumb technique is superior for infant CPR, offering improved depth, reduced variability, and less compression decay.
• An elevated, firm surface, such as a table, is preferred for comfort and reduced provider fatigue.
• The two-thumb technique on an elevated surface is recommended for teaching infant CPR to laypersons.