title: One-handed versus two-handed chest compressions in paediatric cardio-pulmonary resuscitation.
abstract: OBJECTIVE
  To determine emergency department (ED) staff preference for one- or two-handed paediatric chest compressions and to determine if there was a difference in compression rates delivered and fatigability between the techniques.
  
  
  METHODS
  This was a randomised, cross-over observational study of paediatric CPR performed on a standard paediatric manikin by ED staff. Consenting, eligible staff [ED doctors and nurses] performed CPR in pairs with chest compressions delivered using a one- and two-handed technique. The outcomes of interest were compression rates for one- and two-handed CPR, decrease in compression rate over time for each technique and staff preference for technique. Data was analysed using descriptive statistics, Chi Square test and Mann-Whitney U-test as appropriate.
  
  
  RESULTS
  Sixty-two ED staff participated in the study. Compression rates with both techniques were similar and higher than guidelines recommend (133.6 min(-1) for one-handed and 135.7 min(-1) for two-handed respectively). The compression rate slowed by 6.9 compressions/min over 1 min in one-handed compressions compared with 2.6 compressions/min in two-handed compressions (p = 0.0264). 65.6% of participants reported that they preferred the two-handed compression technique.
  
  
  CONCLUSIONS
  This study showed that CPR compression rate is similar with one- and two-handed compression techniques, but compression rate decreased more quickly with the one-handed technique. The majority of staff preferred the two-handed compression technique for reasons of ease, control and uniformity with other CPR techniques.
authors.affiliation: Joseph Epstein Centre for Emergency Medicine Research, The University of Melbourne, Western Hospital, Footscray, Melbourne, Australia.
authors.forename: Emil
authors.initials: E
authors.lastname: Peska
authors.forename: Anne-Maree
authors.initials: AM
authors.lastname: Kelly
authors.forename: Debra
authors.initials: D
authors.lastname: Kerr
authors.forename: Denise
authors.initials: D
authors.lastname: Green
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002648:Child; D006801:Humans; D009726:Nurses; D010820:Physicians; D016896:Treatment Outcome