Should we change chest compression providers every 2 min when performing one-handed chest compressions?

Because the one-handed chest compression (OHCC) technique uses one hand, unlike the two-handed chest compression (THCC) technique, compression depth might be reduced more rapidly in OHCC than THCC. The present study was conducted to determine whether compression depth was affected within 2 min after the start of OHCC in a simulated in-hospital paediatric arrest model.

Forty medical doctors performed continuous OHCC on a child manikin lying on a hard floor using a CPRmeter for 2 min. The hand used to perform the OHCC technique was randomised to the right or left hand. The mean compression depth (MCD) and the mean compression rate (MCR) were calculated at 30 s intervals using the Q-CPR review software.

MCD values decreased significantly with time (0-30 s: 44.3 ± 4.1 mm, 30-60 s: 42.4 ± 4.9 mm, 60-90 s: 40.5 ± 5.8 mm, and 90-120 s: 38.7 ± 5.7 mm; P < 0.001). The MCR also tended to decrease with time (0-30 s: 119.3 ± 12.5/min, 30-60 s: 119.0 ± 13.1/min, 60-90 s: 117.9 ± 14.5/min, 90-120 s: 117.8 ± 14.9/min), and the differences were statistically significant between 30-60 s and 60-90 s (P = 0.037) and between 30-60 s and 90-120 s (P = 0.043).

Compression depth was decreased significantly from 30 s onwards after starting the OHCC technique using a simulated paediatric arrest model. The results of the present study suggest that future strategies should be established to prevent a decrease in compression depth within 1 min during OHCC.