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06:04
Ultrasonographic Assessment During Cardiopulmonary Resuscitation
Published on: October 24, 2020
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New chest compression method in infant resuscitation: Cross thumb technique.
Woochan Jeon1, Jungeon Kim1, Yura Ko2
1Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
Plos One
|August 8, 2022
Summary
The novel cross-thumb technique (CTT) offers improved chest compression depth and correct location during infant CPR compared to the two-finger technique (2FT). This new method may also reduce rescuer pain and fatigue in emergency situations.
Area of Science:
- Pediatric Emergency Medicine
- Cardiopulmonary Resuscitation Techniques
- Simulation-Based Medical Education
Background:
- The two-thumb encircling technique (2TT) is recognized as superior for infant cardiopulmonary resuscitation (CPR) compared to the two-finger technique (2FT).
- However, challenges exist in achieving timely ventilation with the 2TT method.
- The cross-thumb technique (CTT) was developed to potentially combine the benefits of 2TT with the positioning advantages of 2FT for infant CPR.
Purpose of the Study:
- To evaluate and compare the quality of chest compressions and hands-off intervals among the two-finger technique (2FT), two-thumb encircling technique (2TT), and the novel cross-thumb technique (CTT).
- To assess the feasibility of CTT in maintaining CPR performance while potentially facilitating ventilation.
- To compare subjective measures of pain and fatigue experienced by a single rescuer using each technique on an infant CPR manikin.
Main Methods:
- A prospective, randomized, controlled, simulation-based study was conducted using the Resusci® Baby QCPR manikin.
- Participants performed infant CPR with a 30:2 compression-to-ventilation ratio as a single rescuer.
- CPR quality metrics including compression depth, rate, location, release, hands-off times, and ventilation effectiveness were recorded using manikin feedback systems.
Main Results:
- Chest compression depth was significantly greater with CTT and 2TT (42.0 mm) compared to 2FT (40.0 mm) (P<0.05).
- The chest compression fraction (CCF) was highest with 2FT (73.9%) compared to CTT (71.3%) and 2TT (71.2%) (P<0.05).
- Correct compression location was achieved more frequently with CTT and 2TT (100%) than with 2FT (99.0%), and CTT reported lower subjective pain and fatigue scores.
Conclusions:
- The cross-thumb technique (CTT) demonstrates superior chest compression depth compared to the two-finger technique (2FT) in infant CPR.
- CTT may also be advantageous in maintaining correct chest compression location.
- The CTT shows potential for reducing rescuer-reported pain and fatigue during infant CPR simulations.
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