Aim: To evaluate the quality and ergonomic impact of three infant chest compression techniques the two-thumb encircling technique (TTHT), the cross-thumb technique (CTT), and the one-hand open-palm technique (OHT) during two-rescuer infant cardiopulmonary resuscitation (CPR) utilizing a 15:2 compression-to-ventilation ratio. Materials and Methods: This prospective, randomized, crossover simulation study included 50 registered nurses who performed three 2-minute CPR sequences on an infant manikin, each using one of the three techniques. The primary outcomes were the depth of the compression, the percentage of target-range compressions, and the chest compression fraction (CCF). Secondary outcomes encompassed compression rate, recoil, hand position accuracy, excessive compressions, fatigue, pain, perceived difficulty, and hand slippage. We used repeated-measures statistical models to look at the data. Results: Both thumb-based methods (TTHT and CTT) yielded significantly deeper compressions, elevated proportions of target-range compressions, increased CCF, and enhanced accuracy in hand positioning in comparison to OHT (all p<0.01). TTHT and CTT exhibited similar mechanical performance in all primary outcomes. However, CTT had much less fatigue, hand pain, and perceived difficulty than TTHT (all p<0.01). OHT caused shallower compressions, the lowest CCF, more over-depth compressions, and the highest rate of hand slippage. Conclusion: During two-rescuer infant resuscitation, TTHT and CTT are better than OHT at biomechanical CPR quality. CTT has the same compression quality as TTHT but is more comfortable to use, making it a good choice when thumb-based techniques are feasible. OHT should only be used when it is not possible to wrap the chest. More clinical studies are needed to support these simulation results.
Koşargelir et al. (Tue,) studied this question.