Comparison of standard and alternative methods for chest compressions in a single rescuer infant CPR: A prospective simulation study


Autoři: So Hyun Paek aff001;  Do Kyun Kim aff002;  Jin Hee Lee aff003;  Young Ho Kwak aff002
Působiště autorů: CHA Bundang Medical Center, Department of Emergency Medicine, CHA University, Seongnam, Gyeonggi-do, Republic of Korea aff001;  Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea aff002;  Department of Emergency Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea aff003;  College of Medicine, Department of Emergency Medicine, Seoul National University, Seoul, Republic of Korea aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226632

Souhrn

Objective

The aims of this study were to develop a novel three-finger chest compression technique (pinch technique; PT) and an assistive device chest compression technique (plate-assisted technique; PAT) and compare these techniques with conventional techniques.

Design

Prospective, crossover manikin study

Setting

Pediatric emergency department at a tertiary care academic center

Subjects

Fifty medical doctors and medical students

Interventions

Using a manikin, fifty participants performed five different chest compression techniques—two 2-finger techniques (TFT1 and TFT2), two PTs (PT1 and PT2), and the PAT—for 2 minutes with 2 minutes of rest in a randomized sequence.

Measurements and main results

The compression depth (CD), compression rate, recoil, and finger position were recorded. At the study conclusion, each participant completed a 5-point Likert scale-based questionnaire on fatigue, satisfaction and difficulty of performing each technique. The mean CDs were 32.9 mm (TFT1), 30.3 mm (TFT2), 37.3 mm (PT1), 35.0 mm (PT2) and 40.1 mm (PAT) (p<0.001). TFT2 achieved the highest frequency of complete chest recoil, followed by PT1 and TFT1 (88.9%, 86.9%, and 81.4%, respectively, p = 0.003). The highest percentage of correct finger position was achieved by the PAT, followed by the PT1 and PT2 (93.4%, 83.1%, and 80.1%, respectively, p = 0.016). PAT use resulted in higher participant satisfaction, less fatigue, and less difficulty than the other four techniques.

Conclusion

Our new chest compression methods using three fingers and assistive plates showed better CD results than the conventional 2-finger technique.

Klíčová slova:

Cardiac arrest – Critical care and emergency medicine – Fingers – Medical doctors – Pediatrics – Questionnaires – Resuscitation – Thumbs


Zdroje

1. Atkins DL, Everson-Stewart S, Sears GK, Daya M, Osmond MH, Warden CR, et al. Epidemiology and outcomes from out-of-hospital cardiac arrest in children: The resuscitation outcomes consortium epistry-cardiac arrest. Circulation. 2009;119:1484–1491. doi: 10.1161/CIRCULATIONAHA.108.802678 19273724

2. Naim MY, Burke RV, McNally BF, Song L, Griffis HM, Berg RA, et al. Association of bystander cardiopulmonary resuscitation with overall and neurologically favorable survival after pediatric out-of-hospital cardiac arrest in the United States: A report from the cardiac arrest registry to enhance survival surveillance registry. JAMA Pediatr. 2017;171:133–141. doi: 10.1001/jamapediatrics.2016.3643 27837587

3. Sutton RM, Case E, Brown SP, Atkins DL, Nadkarni VM, Kaltman J, et al. A quantitative analysis of out-of-hospital pediatric and adolescent resuscitation quality–A report from the ROC epistry-cardiac arrest. Resuscitation. 2015;93:150–157. doi: 10.1016/j.resuscitation.2015.04.010 25917262

4. Maconochie IK, Bingham R, Eich C, López-Herce J, Rodríguez-Núñez A, Rajka T, et al. European resuscitation council guidelines for resuscitation 2015: Section 6. Paediatric life support. Resuscitation. 2015;95:223–248. doi: 10.1016/j.resuscitation.2015.07.028 26477414

5. Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL, et al. Part 11: Pediatric basic life support and cardiopulmonary resuscitation quality: 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:S519–S525. doi: 10.1161/CIR.0000000000000265 26472999

6. Lee JS, Ahn JY, Kim DK, Kim YH, Lee B, Jhang WK, et al. Part 5. Pediatric basic life support: 2015 Korean guidelines for cardiopulmonary resuscitation. Clin Exp Emerg Med. 2016;3:S39–S47. doi: 10.15441/ceem.16.131 27752645

7. Dorfsman ML, Menegazzi JJ, Wadas RJ, Auble TE. Two-thumb vs. two-finger chest compression in an infant model of prolonged cardiopulmonary resuscitation. Acad Emerg Med. 2000;7:1077–1082. doi: 10.1111/j.1553-2712.2000.tb01255.x 11015237

8. Menegazzi JJ, Auble TE, Nicklas KA, Hosack GM, Rack L, Goode JS. Two-thumb versus two-finger chest compression during CRP in a swine infant model of cardiac arrest. Ann Emerg Med. 1993;22:240–243. doi: 10.1016/s0196-0644(05)80212-4 8427439

9. Houri PK, Frank LR, Menegazzi JJ, Taylor R. A randomized, controlled trial of two-thumb vs two-finger chest compression in a swine infant model of cardiac arrest. Prehosp Emerg Care. 1997;1:65–67. doi: 10.1080/10903129708958789 9709339

10. Whitelaw CC, Slywka B, Goldsmith LJ. Comparison of a two-finger versus two-thumb method for chest compressions by healthcare providers in an infant mechanical model. Resuscitation. 2000;43:213–216. doi: 10.1016/s0300-9572(99)00145-8 10711490

11. Udassi S, Udassi JP, Lamb MA, Theriaque DW, Shuster JJ, Zaritsky AL, et al. Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR. Resuscitation. 2010;81:712–717. doi: 10.1016/j.resuscitation.2009.12.029 20227156

12. Fakhraddin BZ, Shimizu N, Kurosawa S, Sakai H, Miyasaka K, Mizutani S. New method of chest compression for infants in a single rescuer situation: Thumb-index finger technique. J Med Dent Sci. 2011;58:15–22. 23896782

13. Smereka J, Szarpak L, Smereka A, Leung S, Ruetzler K. Evaluation of new two-thumb chest compression technique for infant CPR performed by novice physicians. A randomized, crossover, manikin trial. Am J Emerg Med. 2017;35:604–609. doi: 10.1016/j.ajem.2016.12.045 28040386

14. Jo CH, Cho GC, Lee CH. Two-thumb encircling technique over the head of patients in the setting of lone rescuer infant CPR occurred during ambulance transfer: A crossover simulation study. Pediatr Emerg Care. 2017;33:462–466. doi: 10.1097/PEC.0000000000000833 27668920

15. Jung WJ, Hwang SO, Kim HI, Cha YS, Kim OH, Kim H, et al. 'Knocking-fingers' chest compression technique in infant cardiac arrest: Single-rescuer manikin study. Eur J Emerg Med. 2019;26:261–265. doi: 10.1097/MEJ.0000000000000539 29384754

16. Wang B-S, Wang X-J, Gong L-K. The construction of a Williams design and randomization in cross-over clinical trials using SAS. J Stat Softw. 2009;29:1–10.

17. Sutton RM, French B, Niles DE, Donoghue A, Topjian AA, Nishisaki A, et al. 2010 American heart association recommended compression depths during pediatric in-hospital resuscitations are associated with survival. Resuscitation. 2014;85:1179–1184. doi: 10.1016/j.resuscitation.2014.05.007 24842846

18. Kim YS, Oh JH, Kim CW, Kim SE, Lee DH, Hong JY. Which fingers should we perform two-finger chest compression technique with when performing cardiopulmonary resuscitation on an infant in cardiac arrest? J Korean Med Sci. 2016;31:997–1002. doi: 10.3346/jkms.2016.31.6.997 27247512

19. Lee SH, Cho YC, Ryu S, Lee JW, Kim SW, Yoo IS, et al. A comparison of the area of chest compression by the superimposed-thumb and the alongside-thumb techniques for infant cardiopulmonary resuscitation. Resuscitation. 2011;82:1214–1217. doi: 10.1016/j.resuscitation.2011.04.016 21620550


Článek vyšel v časopise

PLOS One


2019 Číslo 12