Evaluation of a newly developed infant chest compression technique: A randomized crossover manikin trial

Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The "new 2-thumb technique" (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands...

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Veröffentlicht in:	Medicine (Baltimore) 2017-04, Vol.96 (14), p.e5915-e5915
Hauptverfasser:	Smereka, Jacek, Bielski, Karol, Ladny, Jerzy R., Ruetzler, Kurt, Szarpak, Lukasz
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Sprache:	eng
Schlagworte:	Cardiopulmonary Resuscitation - methods Clinical Trial/Experimental Study Cross-Over Studies Humans Infant Manikins
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creator	Smereka, Jacek Bielski, Karol Ladny, Jerzy R. Ruetzler, Kurt Szarpak, Lukasz
description	Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The "new 2-thumb technique" (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting. A total of 73 paramedics with at least 1 year of clinical experience performed 3 CPR settings with a chest compression:ventilation ratio of 15:2, according to current guidelines. Chest compression was performed with 1 out of the 3 chest compression techniques in a randomized sequence. Chest compression rate and depth, chest decompression, and adequate ventilation after chest compression served as outcome parameters. The chest compression depth was 29 (IQR, 28-29) mm in the TFT group, 42 (40-43) mm in the TTHT group, and 40 (39-40) mm in the nTTT group (TFT vs TTHT, P
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The "new 2-thumb technique" (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting. A total of 73 paramedics with at least 1 year of clinical experience performed 3 CPR settings with a chest compression:ventilation ratio of 15:2, according to current guidelines. Chest compression was performed with 1 out of the 3 chest compression techniques in a randomized sequence. Chest compression rate and depth, chest decompression, and adequate ventilation after chest compression served as outcome parameters. The chest compression depth was 29 (IQR, 28-29) mm in the TFT group, 42 (40-43) mm in the TTHT group, and 40 (39-40) mm in the nTTT group (TFT vs TTHT, P < 0.001; TFT vs nTTT, P < 0.001; TTHT vs nTTT, P < 0.01). The median compression rate with TFT, TTHT, and nTTT varied and amounted to 136 (IQR, 133-144) min versus 117 (115-121) min versus 111 (109-113) min. There was a statistically significant difference in the compression rate between TFT and TTHT (P < 0.001), TFT and nTTT (P < 0.001), as well as TTHT and nTTT (P < 0.001). Incorrect decompressions after CC were significantly increased in the TTHT group compared with the TFT (P < 0.001) and the nTTT (P < 0.001) group. The nTTT provides adequate chest compression depth and rate and was associated with adequate chest decompression and possibility to adequately ventilate the infant manikin. Further clinical studies are necessary to confirm these initial findings.]]></description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000005915</identifier><identifier>PMID: 28383397</identifier><language>eng</language><publisher>United States: The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Cardiopulmonary Resuscitation - methods ; Clinical Trial/Experimental Study ; Cross-Over Studies ; Humans ; Infant ; Manikins</subject><ispartof>Medicine (Baltimore), 2017-04, Vol.96 (14), p.e5915-e5915</ispartof><rights>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2854-f225fa551c255cc3eaab76673b924dbc0083b43dd4fbc5328df5774d84cb044a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411181/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411181/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28383397$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smereka, Jacek</creatorcontrib><creatorcontrib>Bielski, Karol</creatorcontrib><creatorcontrib>Ladny, Jerzy R.</creatorcontrib><creatorcontrib>Ruetzler, Kurt</creatorcontrib><creatorcontrib>Szarpak, Lukasz</creatorcontrib><title>Evaluation of a newly developed infant chest compression technique: A randomized crossover manikin trial</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description><![CDATA[Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The "new 2-thumb technique" (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting. A total of 73 paramedics with at least 1 year of clinical experience performed 3 CPR settings with a chest compression:ventilation ratio of 15:2, according to current guidelines. Chest compression was performed with 1 out of the 3 chest compression techniques in a randomized sequence. Chest compression rate and depth, chest decompression, and adequate ventilation after chest compression served as outcome parameters. The chest compression depth was 29 (IQR, 28-29) mm in the TFT group, 42 (40-43) mm in the TTHT group, and 40 (39-40) mm in the nTTT group (TFT vs TTHT, P < 0.001; TFT vs nTTT, P < 0.001; TTHT vs nTTT, P < 0.01). The median compression rate with TFT, TTHT, and nTTT varied and amounted to 136 (IQR, 133-144) min versus 117 (115-121) min versus 111 (109-113) min. There was a statistically significant difference in the compression rate between TFT and TTHT (P < 0.001), TFT and nTTT (P < 0.001), as well as TTHT and nTTT (P < 0.001). Incorrect decompressions after CC were significantly increased in the TTHT group compared with the TFT (P < 0.001) and the nTTT (P < 0.001) group. The nTTT provides adequate chest compression depth and rate and was associated with adequate chest decompression and possibility to adequately ventilate the infant manikin. Further clinical studies are necessary to confirm these initial findings.]]></description><subject>Cardiopulmonary Resuscitation - methods</subject><subject>Clinical Trial/Experimental Study</subject><subject>Cross-Over Studies</subject><subject>Humans</subject><subject>Infant</subject><subject>Manikins</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU9v1DAQxS0EokvhEyChHLmk-G_scECq2tJWatVLOVuOPSGmjr3Yya7KpyfbLVXLHDyS_XtvPHoIfST4iOBWfrk-PcLPSrREvEIrIlhTi7bhr9EKYypq2Up-gN6V8gtjwiTlb9EBVUwx1soVGs42Jsxm8ilWqa9MFWEb7isHGwhpDa7ysTdxquwAZTnTuM5Qyo6ewA7R_57ha3VcZRNdGv2fRWBzKiVtIFejif7OL2T2JrxHb3oTCnx47Ifox_ez25OL-urm_PLk-Kq2VAle95SK3ghBLBXCWgbGdLJpJOtayl1nMVas48w53ndWMKpcL6TkTnHbYc4NO0Tf9r7ruRvBWYhTNkGvsx9NvtfJeP3yJfpB_0wbLTghRJHF4POjQU7LdmXSoy8WQjAR0lw0UYor1YimXVC2Rx92ztA_jSFY7zLS16f6_4wW1afnP3zS_AtlAfge2KYwQS53Yd5C1gOYMA0PfkK2tKaYSMyxxPXuirO_G4GfCQ</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Smereka, Jacek</creator><creator>Bielski, Karol</creator><creator>Ladny, Jerzy R.</creator><creator>Ruetzler, Kurt</creator><creator>Szarpak, Lukasz</creator><general>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</general><general>Wolters Kluwer Health</general><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><scope>5PM</scope></search><sort><creationdate>20170401</creationdate><title>Evaluation of a newly developed infant chest compression technique: A randomized crossover manikin trial</title><author>Smereka, Jacek ; Bielski, Karol ; Ladny, Jerzy R. ; Ruetzler, Kurt ; Szarpak, Lukasz</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2854-f225fa551c255cc3eaab76673b924dbc0083b43dd4fbc5328df5774d84cb044a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Cardiopulmonary Resuscitation - methods</topic><topic>Clinical Trial/Experimental Study</topic><topic>Cross-Over Studies</topic><topic>Humans</topic><topic>Infant</topic><topic>Manikins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smereka, Jacek</creatorcontrib><creatorcontrib>Bielski, Karol</creatorcontrib><creatorcontrib>Ladny, Jerzy R.</creatorcontrib><creatorcontrib>Ruetzler, Kurt</creatorcontrib><creatorcontrib>Szarpak, Lukasz</creatorcontrib><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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smereka, Jacek</au><au>Bielski, Karol</au><au>Ladny, Jerzy R.</au><au>Ruetzler, Kurt</au><au>Szarpak, Lukasz</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of a newly developed infant chest compression technique: A randomized crossover manikin trial</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>96</volume><issue>14</issue><spage>e5915</spage><epage>e5915</epage><pages>e5915-e5915</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract><![CDATA[Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The "new 2-thumb technique" (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting. A total of 73 paramedics with at least 1 year of clinical experience performed 3 CPR settings with a chest compression:ventilation ratio of 15:2, according to current guidelines. Chest compression was performed with 1 out of the 3 chest compression techniques in a randomized sequence. Chest compression rate and depth, chest decompression, and adequate ventilation after chest compression served as outcome parameters. The chest compression depth was 29 (IQR, 28-29) mm in the TFT group, 42 (40-43) mm in the TTHT group, and 40 (39-40) mm in the nTTT group (TFT vs TTHT, P < 0.001; TFT vs nTTT, P < 0.001; TTHT vs nTTT, P < 0.01). The median compression rate with TFT, TTHT, and nTTT varied and amounted to 136 (IQR, 133-144) min versus 117 (115-121) min versus 111 (109-113) min. There was a statistically significant difference in the compression rate between TFT and TTHT (P < 0.001), TFT and nTTT (P < 0.001), as well as TTHT and nTTT (P < 0.001). Incorrect decompressions after CC were significantly increased in the TTHT group compared with the TFT (P < 0.001) and the nTTT (P < 0.001) group. The nTTT provides adequate chest compression depth and rate and was associated with adequate chest decompression and possibility to adequately ventilate the infant manikin. Further clinical studies are necessary to confirm these initial findings.]]></abstract><cop>United States</cop><pub>The Authors. 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subjects	Cardiopulmonary Resuscitation - methods Clinical Trial/Experimental Study Cross-Over Studies Humans Infant Manikins
title	Evaluation of a newly developed infant chest compression technique: A randomized crossover manikin trial
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