What is the correct depth of chest compression for infants and children? A radiological study.
OBJECTIVE
For infant and child resuscitation, current basic life support guidelines recommend a compression depth of one third to one half of the anteroposterior chest diameter. This study was conducted to assess the actual compression depths in infants and children when current guidelines are strictly followed.


METHODS
Chest computed tomography scans of 36 infants (<1 year old) and 38 children (1-8 years old) were reviewed. Patient demographic data were collected from medical records. Measurements of the anteroposterior diameter from chest computed tomography scans were taken from the anterior skin at either the internipple line or the middle of the lower half of the sternum, perpendicular to the skin on the posterior thorax.


RESULTS
In the infant group (25 boys, 11 girls), the mean age was 3.6 months. In the child-age group (21 boys, 17 girls), the mean age was 4.0 years. Compression depths were 3.4 to 5.1 cm in the infant group and 4.4 to 6.6 cm in the child group when current guidelines were followed. There was no difference in compression depths measured at internipple line versus in the lower half of the sternum. The intrathoracic structures observed beneath these 2 suggested that compression landmarks were similar.


CONCLUSIONS
Radiological assessment of infants' and children's chests indicates similar or higher compression depths for infants and children versus the recommended compression depths for adults (3.8-5.1 cm) according to current guidelines. More evidence is needed to guide the proper depth of chest compression in pediatric populations.
Kao
Pei-Chieh
PC
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Chiang
Wen-Chu
WC
Yang
Chih-Wei
CW
Chen
Shyh-Jye
SJ
Liu
Yueh-Ping
YP
Lee
Chien-Chang
CC
Hsidh
Ming-Ju
MJ
Ko
Patrick Chow-In
PC
Chen
Shyr-Chyr
SC
Ma
Matthew Huei-Ming
MH
D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards; D002648:Child; D002675:Child, Preschool; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013249:Sternum / Q000000981:diagnostic imaging