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Biomechanical analysis of force distribution in one-handed and two-handed child chest compression- a randomized

Jui-Yi Tsou1, Chia-Lung Kao2, Yi-Fang Tu3

  • 1Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.

BMC Emergency Medicine
|January 23, 2022
PubMed

Insights

Two-handed (TH) external chest compressions (ECC) in children provide more even force distribution and greater compression force compared to one-hand (OH) ECC. TH ECC also results in less rescuer fatigue and pain.

Area of Science:

  • Emergency Medicine
  • Cardiopulmonary Resuscitation
  • Pediatric Resuscitation

Background:

  • Effective external chest compression (ECC) relies on even force distribution.
  • Limited research compares force distribution between one-hand (OH) and two-handed (TH) ECC in children.
  • Investigating these techniques is crucial for optimizing pediatric resuscitation.

Purpose of the Study:

  • To compare force distribution during OH and TH ECC in children.
  • To assess rescuer-perceived fatigue and discomfort/pain between OH and TH ECC techniques.
  • To determine the optimal ECC method for pediatric resuscitation.

Main Methods:

  • A crossover manikin study involving 35 registered nurses.
  • Participants performed lone rescuer ECC using both TH and OH techniques for 2 minutes each at a rate of at least 100 compressions/min.
  • A Resusci Junior Basic manikin with a MatScan pressure system measured force; modified Borg scale and NRS assessed fatigue and pain.

Main Results:

  • TH ECC generated significantly greater maximum compression force (56.58 ± 13.67 kg) than OH ECC (45.12 ± 7.90 kg).
  • TH ECC demonstrated a more even force distribution, indicated by a smaller maximum-minimum force difference (52.24 ± 13.43 kg vs. 41.36 ± 7.57 kg).
  • Rescuers reported significantly less perceived exertion and pain with TH ECC compared to OH ECC.

Conclusions:

  • Two-handed ECC in children results in more effective compression with better force distribution.
  • The TH method is superior to the OH method in reducing rescuer fatigue and physical pain.
  • These findings support the use of TH ECC for improved outcomes in pediatric resuscitation.
Abstract

Keywords:
BiomechanicsCardiopulmonary resuscitationChest compressionChild

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