Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR
Abstract Objective Infant CPR guidelines recommend two-finger chest compression with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. We hypothesized that lone rescuer two-thumb CP...
Gespeichert in:
| Veröffentlicht in: | Resuscitation 2010-06, Vol.81 (6), p.712-717 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 717 |
|---|---|
| container_issue | 6 |
| container_start_page | 712 |
| container_title | Resuscitation |
| container_volume | 81 |
| creator | Udassi, Sharda Udassi, Jai P Lamb, Melissa A Theriaque, Douglas W Shuster, Jonathan J Zaritsky, Arno L Haque, Ikram U |
| description | Abstract Objective Infant CPR guidelines recommend two-finger chest compression with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. We hypothesized that lone rescuer two-thumb CPR is associated with increased ventilation cycle time, decreased ventilation quality and fewer chest compressions compared to two-finger CPR in an infant manikin model. Design Crossover observational study randomizing 34 healthcare providers to perform 2 min CPR at a compression rate of 100 min−1 using a 30:2 compression:ventilation ratio comparing two-thumb vs. two-finger techniques. Methods A Laerdal™ Baby ALS Trainer manikin was modified to digitally record compression rate, compression depth and compression pressure and ventilation cycle time (two mouth-to-mouth breaths). Manikin chest rise with breaths was video recorded and later reviewed by two blinded CPR instructors for percent effective breaths. Data (mean ± SD) were analyzed using a two-tailed paired t -test. Significance was defined qualitatively as p ≤ 0.05. Result Mean % effective breaths were 90 ± 18.6% in two-thumb and 88.9 ± 21.1% in two-finger, p = 0.65. Mean time (s) to deliver two mouth-to-mouth breaths was 7.6 ± 1.6 in two-thumb and 7.0 ± 1.5 in two-finger, p < 0.0001. Mean delivered compressions per minute were 87 ± 11 in two-thumb and 92 ± 12 in two-finger, p = 0.0005. Two-thumb resulted in significantly higher compression depth and compression pressure compared to the two-finger technique. Conclusion Healthcare providers required 0.6 s longer time to deliver two breaths during two-thumb lone rescuer infant CPR, but there was no significant difference in percent effective breaths delivered between the two techniques. Two-thumb CPR had 4 fewer delivered compressions per minute, which may be offset by far more effective compression depth and compression pressure compared to two-finger technique. |
| doi_str_mv | 10.1016/j.resuscitation.2009.12.029 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_733317572</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S030095721000016X</els_id><sourcerecordid>733317572</sourcerecordid><originalsourceid>FETCH-LOGICAL-c467t-54e0e8781f2f8be6087e5b3f168a46aa9ec51b4416bc08848c9c8ca8955d974e3</originalsourceid><addsrcrecordid>eNqNkl1rFDEUhoModq3-BQmIeDVjkplMMgiCLLUVChat4JUhkzljs51J1nwo_fdm2W3VXnkVOHnOOS8PB6EXlNSU0O71pg4QczQ26WS9qxkhfU1ZTVj_AK2oFE1FuSAP0Yo0hFQ9F-wIPYlxQwhpeC8eoyNGGBOUdyv07fKXr9JVXgacwFw5-yMDthHHvIVgfcDJ41SQybrvEP5ixhxKCc_eAS55TC6_1k3aJbxoZ6-tw-uLT0_Ro0nPEZ4d3mP05f3J5fqsOv94-mH97rwybSdSxVsgIIWkE5vkAB2RAvjQTLSTuu207sFwOrQt7QZDpGyl6Y00Wvacj71ooTlGr_Zzt8GXdDGpxUYD86wd-ByVaJqGimKikG_2pAk-xgCT2ga76HCjKFE7v2qj_vGrdn4VZar4Ld3PD3vysMB413srtAAvD4CORs9T0M7Y-IdjkgvO2sKd7DkoVn5aCKosBGdgtAFMUqO3_xno7b05ZrbOltXXcANx43NwRbyiKpYG9Xl3EruLoOUYyuyvzW8j-LcJ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>733317572</pqid></control><display><type>article</type><title>Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Udassi, Sharda ; Udassi, Jai P ; Lamb, Melissa A ; Theriaque, Douglas W ; Shuster, Jonathan J ; Zaritsky, Arno L ; Haque, Ikram U</creator><creatorcontrib>Udassi, Sharda ; Udassi, Jai P ; Lamb, Melissa A ; Theriaque, Douglas W ; Shuster, Jonathan J ; Zaritsky, Arno L ; Haque, Ikram U</creatorcontrib><description>Abstract Objective Infant CPR guidelines recommend two-finger chest compression with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. We hypothesized that lone rescuer two-thumb CPR is associated with increased ventilation cycle time, decreased ventilation quality and fewer chest compressions compared to two-finger CPR in an infant manikin model. Design Crossover observational study randomizing 34 healthcare providers to perform 2 min CPR at a compression rate of 100 min−1 using a 30:2 compression:ventilation ratio comparing two-thumb vs. two-finger techniques. Methods A Laerdal™ Baby ALS Trainer manikin was modified to digitally record compression rate, compression depth and compression pressure and ventilation cycle time (two mouth-to-mouth breaths). Manikin chest rise with breaths was video recorded and later reviewed by two blinded CPR instructors for percent effective breaths. Data (mean ± SD) were analyzed using a two-tailed paired t -test. Significance was defined qualitatively as p ≤ 0.05. Result Mean % effective breaths were 90 ± 18.6% in two-thumb and 88.9 ± 21.1% in two-finger, p = 0.65. Mean time (s) to deliver two mouth-to-mouth breaths was 7.6 ± 1.6 in two-thumb and 7.0 ± 1.5 in two-finger, p < 0.0001. Mean delivered compressions per minute were 87 ± 11 in two-thumb and 92 ± 12 in two-finger, p = 0.0005. Two-thumb resulted in significantly higher compression depth and compression pressure compared to the two-finger technique. Conclusion Healthcare providers required 0.6 s longer time to deliver two breaths during two-thumb lone rescuer infant CPR, but there was no significant difference in percent effective breaths delivered between the two techniques. Two-thumb CPR had 4 fewer delivered compressions per minute, which may be offset by far more effective compression depth and compression pressure compared to two-finger technique.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/j.resuscitation.2009.12.029</identifier><identifier>PMID: 20227156</identifier><identifier>CODEN: RSUSBS</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiopulmonary resuscitation ; Cardiopulmonary Resuscitation - methods ; Chest compression ; Cross-Over Studies ; Emergency ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Female ; Fingers ; Humans ; Infant ; Intensive care medicine ; Male ; Manikins ; Medical sciences ; Middle Aged ; Mouth-to-mouth resuscitation ; Respiration ; Single-Blind Method ; Thumb ; Time Factors ; Ventilation ; Young Adult</subject><ispartof>Resuscitation, 2010-06, Vol.81 (6), p.712-717</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2010 Elsevier Ireland Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-54e0e8781f2f8be6087e5b3f168a46aa9ec51b4416bc08848c9c8ca8955d974e3</citedby><cites>FETCH-LOGICAL-c467t-54e0e8781f2f8be6087e5b3f168a46aa9ec51b4416bc08848c9c8ca8955d974e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S030095721000016X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22857524$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20227156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Udassi, Sharda</creatorcontrib><creatorcontrib>Udassi, Jai P</creatorcontrib><creatorcontrib>Lamb, Melissa A</creatorcontrib><creatorcontrib>Theriaque, Douglas W</creatorcontrib><creatorcontrib>Shuster, Jonathan J</creatorcontrib><creatorcontrib>Zaritsky, Arno L</creatorcontrib><creatorcontrib>Haque, Ikram U</creatorcontrib><title>Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Abstract Objective Infant CPR guidelines recommend two-finger chest compression with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. We hypothesized that lone rescuer two-thumb CPR is associated with increased ventilation cycle time, decreased ventilation quality and fewer chest compressions compared to two-finger CPR in an infant manikin model. Design Crossover observational study randomizing 34 healthcare providers to perform 2 min CPR at a compression rate of 100 min−1 using a 30:2 compression:ventilation ratio comparing two-thumb vs. two-finger techniques. Methods A Laerdal™ Baby ALS Trainer manikin was modified to digitally record compression rate, compression depth and compression pressure and ventilation cycle time (two mouth-to-mouth breaths). Manikin chest rise with breaths was video recorded and later reviewed by two blinded CPR instructors for percent effective breaths. Data (mean ± SD) were analyzed using a two-tailed paired t -test. Significance was defined qualitatively as p ≤ 0.05. Result Mean % effective breaths were 90 ± 18.6% in two-thumb and 88.9 ± 21.1% in two-finger, p = 0.65. Mean time (s) to deliver two mouth-to-mouth breaths was 7.6 ± 1.6 in two-thumb and 7.0 ± 1.5 in two-finger, p < 0.0001. Mean delivered compressions per minute were 87 ± 11 in two-thumb and 92 ± 12 in two-finger, p = 0.0005. Two-thumb resulted in significantly higher compression depth and compression pressure compared to the two-finger technique. Conclusion Healthcare providers required 0.6 s longer time to deliver two breaths during two-thumb lone rescuer infant CPR, but there was no significant difference in percent effective breaths delivered between the two techniques. Two-thumb CPR had 4 fewer delivered compressions per minute, which may be offset by far more effective compression depth and compression pressure compared to two-finger technique.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiopulmonary Resuscitation - methods</subject><subject>Chest compression</subject><subject>Cross-Over Studies</subject><subject>Emergency</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Female</subject><subject>Fingers</subject><subject>Humans</subject><subject>Infant</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Manikins</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mouth-to-mouth resuscitation</subject><subject>Respiration</subject><subject>Single-Blind Method</subject><subject>Thumb</subject><subject>Time Factors</subject><subject>Ventilation</subject><subject>Young Adult</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkl1rFDEUhoModq3-BQmIeDVjkplMMgiCLLUVChat4JUhkzljs51J1nwo_fdm2W3VXnkVOHnOOS8PB6EXlNSU0O71pg4QczQ26WS9qxkhfU1ZTVj_AK2oFE1FuSAP0Yo0hFQ9F-wIPYlxQwhpeC8eoyNGGBOUdyv07fKXr9JVXgacwFw5-yMDthHHvIVgfcDJ41SQybrvEP5ixhxKCc_eAS55TC6_1k3aJbxoZ6-tw-uLT0_Ro0nPEZ4d3mP05f3J5fqsOv94-mH97rwybSdSxVsgIIWkE5vkAB2RAvjQTLSTuu207sFwOrQt7QZDpGyl6Y00Wvacj71ooTlGr_Zzt8GXdDGpxUYD86wd-ByVaJqGimKikG_2pAk-xgCT2ga76HCjKFE7v2qj_vGrdn4VZar4Ld3PD3vysMB413srtAAvD4CORs9T0M7Y-IdjkgvO2sKd7DkoVn5aCKosBGdgtAFMUqO3_xno7b05ZrbOltXXcANx43NwRbyiKpYG9Xl3EruLoOUYyuyvzW8j-LcJ</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Udassi, Sharda</creator><creator>Udassi, Jai P</creator><creator>Lamb, Melissa A</creator><creator>Theriaque, Douglas W</creator><creator>Shuster, Jonathan J</creator><creator>Zaritsky, Arno L</creator><creator>Haque, Ikram U</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100601</creationdate><title>Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR</title><author>Udassi, Sharda ; Udassi, Jai P ; Lamb, Melissa A ; Theriaque, Douglas W ; Shuster, Jonathan J ; Zaritsky, Arno L ; Haque, Ikram U</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-54e0e8781f2f8be6087e5b3f168a46aa9ec51b4416bc08848c9c8ca8955d974e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiopulmonary resuscitation</topic><topic>Cardiopulmonary Resuscitation - methods</topic><topic>Chest compression</topic><topic>Cross-Over Studies</topic><topic>Emergency</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Female</topic><topic>Fingers</topic><topic>Humans</topic><topic>Infant</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Manikins</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mouth-to-mouth resuscitation</topic><topic>Respiration</topic><topic>Single-Blind Method</topic><topic>Thumb</topic><topic>Time Factors</topic><topic>Ventilation</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Udassi, Sharda</creatorcontrib><creatorcontrib>Udassi, Jai P</creatorcontrib><creatorcontrib>Lamb, Melissa A</creatorcontrib><creatorcontrib>Theriaque, Douglas W</creatorcontrib><creatorcontrib>Shuster, Jonathan J</creatorcontrib><creatorcontrib>Zaritsky, Arno L</creatorcontrib><creatorcontrib>Haque, Ikram U</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Udassi, Sharda</au><au>Udassi, Jai P</au><au>Lamb, Melissa A</au><au>Theriaque, Douglas W</au><au>Shuster, Jonathan J</au><au>Zaritsky, Arno L</au><au>Haque, Ikram U</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>81</volume><issue>6</issue><spage>712</spage><epage>717</epage><pages>712-717</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><coden>RSUSBS</coden><abstract>Abstract Objective Infant CPR guidelines recommend two-finger chest compression with a lone rescuer and two-thumb with two rescuers. Two-thumb provides better chest compression but is perceived to be associated with increased ventilation hands-off time. We hypothesized that lone rescuer two-thumb CPR is associated with increased ventilation cycle time, decreased ventilation quality and fewer chest compressions compared to two-finger CPR in an infant manikin model. Design Crossover observational study randomizing 34 healthcare providers to perform 2 min CPR at a compression rate of 100 min−1 using a 30:2 compression:ventilation ratio comparing two-thumb vs. two-finger techniques. Methods A Laerdal™ Baby ALS Trainer manikin was modified to digitally record compression rate, compression depth and compression pressure and ventilation cycle time (two mouth-to-mouth breaths). Manikin chest rise with breaths was video recorded and later reviewed by two blinded CPR instructors for percent effective breaths. Data (mean ± SD) were analyzed using a two-tailed paired t -test. Significance was defined qualitatively as p ≤ 0.05. Result Mean % effective breaths were 90 ± 18.6% in two-thumb and 88.9 ± 21.1% in two-finger, p = 0.65. Mean time (s) to deliver two mouth-to-mouth breaths was 7.6 ± 1.6 in two-thumb and 7.0 ± 1.5 in two-finger, p < 0.0001. Mean delivered compressions per minute were 87 ± 11 in two-thumb and 92 ± 12 in two-finger, p = 0.0005. Two-thumb resulted in significantly higher compression depth and compression pressure compared to the two-finger technique. Conclusion Healthcare providers required 0.6 s longer time to deliver two breaths during two-thumb lone rescuer infant CPR, but there was no significant difference in percent effective breaths delivered between the two techniques. Two-thumb CPR had 4 fewer delivered compressions per minute, which may be offset by far more effective compression depth and compression pressure compared to two-finger technique.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>20227156</pmid><doi>10.1016/j.resuscitation.2009.12.029</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0300-9572 |
| ispartof | Resuscitation, 2010-06, Vol.81 (6), p.712-717 |
| issn | 0300-9572 1873-1570 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_733317572 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiopulmonary resuscitation Cardiopulmonary Resuscitation - methods Chest compression Cross-Over Studies Emergency Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Female Fingers Humans Infant Intensive care medicine Male Manikins Medical sciences Middle Aged Mouth-to-mouth resuscitation Respiration Single-Blind Method Thumb Time Factors Ventilation Young Adult |
| title | Two-thumb technique is superior to two-finger technique during lone rescuer infant manikin CPR |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T22%3A12%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Two-thumb%20technique%20is%20superior%20to%20two-finger%20technique%20during%20lone%20rescuer%20infant%20manikin%20CPR&rft.jtitle=Resuscitation&rft.au=Udassi,%20Sharda&rft.date=2010-06-01&rft.volume=81&rft.issue=6&rft.spage=712&rft.epage=717&rft.pages=712-717&rft.issn=0300-9572&rft.eissn=1873-1570&rft.coden=RSUSBS&rft_id=info:doi/10.1016/j.resuscitation.2009.12.029&rft_dat=%3Cproquest_cross%3E733317572%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=733317572&rft_id=info:pmid/20227156&rft_els_id=1_s2_0_S030095721000016X&rfr_iscdi=true |