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Volume 2 Supplement 1

ESICM LIVES 2014

  • Poster presentation
  • Open Access

0355. Optimal chest compression technique for pediatric arrest victims

  • 1 and
  • 1
Intensive Care Medicine Experimental20142 (Suppl 1) :P21

https://doi.org/10.1186/2197-425X-2-S1-P21

  • Published:

Keywords

  • Chest Compression
  • Compression Rate
  • Compression Technique
  • Respiratory Arrest
  • Depth Change

Introduction

In pediatric cardiopulmonary resuscitation (CPR), high-quality chest compressions (CCs) are essential to successful resuscitation, although most pediatric arrests are caused by respiratory arrest. Therefore, current guidelines emphasize deeper and faster CCs, with complete chest recoil between contractions.1, 2 These guidelines further indicate that rescuers may use a one-hand or two-hand technique for pediatric compressions, thereby allowing rescuers to adapt the technique to the victim's size and rescuer's strength. However, no previous studies have examined the quality of CCs, including the use of deeper and faster CCs with complete chest recoil emphasized in the guidelines. Additionally, no study has assessed compression quality of the one-hand technique comparing the right and left hands.

Objectives

The aim of this study was to assess the quality of CCs performed by inexperienced rescuers using three different techniques: two-hand (2H), right one-hand (R1), and left one-hand (L1).

Methods

We performed a prospective, randomized, crossover study in a simulated 6-year-old pediatric manikin model. Each participant performed 2-minute continuous CCs, using three different techniques (2H, R1, and L1). CC quality data, including compression rate, compression depth, and leaning, were collected and analyzed. To examine trends in CC performance over time, each 2-minute period was divided into six consecutive 20-second epochs.

Results

The 36 participants completed 108 two-minute trials, consisting of a total of 25,030 CCs. The mean compression rates (95% confidence interval [CI]) were as follows: 2H1, 116.8 compressions/minute (111.7-121.9); L1, 115.0 compressions/minute (109.9-120.1); and R1, 115.5 compressions/minute (110.4-120.6) (p=0.565). The mean compression depth for 2H was 38.7 mm (37.1-40.2), which was higher than for L1 (36.3 mm [34.8-37.9]) or R1 (35.4 mm [33.9-37.0]) (p< 0.001). The leaning rate was higher with 2H than L1 or R1 (p=0.021). Chest compression depth per 20-second epoch declined over time, regardless of the technique (p< 0.001). The pattern of compression depth change over time was similar for all techniques (p>0.999).

Conclusions

For pediatric cardiopulmonary resuscitation by inexperienced rescuers, the two hand CC technique has the advantage of producing deeper compressions than the one-hand technique, but it is accompanied by more frequent leaning. For the one-hand techniques, the right and left hand produced CCs of similar quality.

Declarations

Grant acknowledgment

None.

Authors’ Affiliations

(1)
Yonsei University College of Medicine, Department of Emergency Medicine, Seoul, Korea, Republic of

References

  1. Biarent D, Bingham R, Eich C, et al.: European Resuscitation Council guidelines for resuscitation 2010 section 6. paediatric life support. Resuscitation 2010, 81: 1364–88. 10.1016/j.resuscitation.2010.08.012PubMedView ArticleGoogle Scholar
  2. Berg MD, Schexnayder SM, Chameides L, et al.: Part 13: Pediatric basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2010, 18 Suppl 3: S862–75.View ArticleGoogle Scholar

Copyright

© Kim and Park; licensee Springer. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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