title: Two-thumb-encircling hands technique is more advisable than 2-finger technique when lone rescuer performs cardiopulmonary resuscitation on infant manikin.
abstract: OBJECTIVE
  The 2010 guidelines recommend new requirements of the chest compression depth for infant. The compression technique recommendation for infant remains the 2-finger (TF) technique for lone rescuer and the 2-thumb-encircling hands technique for 2 rescuers. We hypothesized that the TF technique cannot result in an enough compression depth to meet the guideline requirements and that the 2-thumb-encircling hands technique will not affect the ventilation.
  
  
  METHODS
  Crossover experimental study randomizes 27 health care providers to perform 2 sets of 5-minute cardiopulmonary resuscitation using a 30:2 compression/ventilation ratio to compare TF and 2-thumb-encircling hands techniques. A Laerdal Resusci Baby QCPR manikin equipped with PC SkillReporting System was used for measuring and recording cardiopulmonary resuscitation data. Data (mean ± SD) were analyzed by using a paired t test. Significance was defined qualitatively as P ≤ .05.
  
  
  RESULTS
  Mean compression depths were 39.25 ± 3.06 cm in the TF technique and 42.37 ± 1.15 cm in the 2-thumb-encircling hands technique, P < .001. Two-finger technique had significant lower fractions of correct hand position than 2-thumb-encircling hands technique (96.56% ± 6.74% vs 99.41% ± 2.52%, P < .05). The fatigue point appears much earlier in TF than in 2-thumb-encircling hands. No difference was identified on ventilation between 2 groups.
  
  
  CONCLUSIONS
  The 2-thumb-encircling hands technique can produce a compression depth meeting the current guidelines recommendation without negative influence on ventilation, whereas the TF technique cannot. The 2-thumb-encircling hands technique generates a significant higher ratio of correct compression position than the TF technique. Furthermore, the 2-thumb-encircling hands technique is less fatiguing than the TF technique.
authors: Emergency Department, Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School, Shanghai, People's Republic of China.
authors: Jie
authors: J
authors: Jiang
authors: Emergency Department, Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School, Shanghai, People's Republic of China.
authors: Yaru
authors: Y
authors: Zou
authors: Emergency Department, Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School, Shanghai, People's Republic of China.
authors: Wen
authors: W
authors: Shi
authors: Emergency Department, Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School, Shanghai, People's Republic of China.
authors: Ying
authors: Y
authors: Zhu
authors: Emergency Department, Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School, Shanghai, People's Republic of China.
authors: Ranjun
authors: R
authors: Tao
authors: Ruijin Clinical Medical College, Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School, Shanghai, People's Republic of China.
authors: Ying
authors: Y
authors: Jiang
authors: Emergency Department, Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School, Shanghai, People's Republic of China.
authors: Yiming
authors: Y
authors: Lu
authors: Emergency Department, Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School, Shanghai, People's Republic of China. Electronic address: tongjj_h@163.com.
authors: Jianjing
authors: J
authors: Tong
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D018592:Cross-Over Studies; D005385:Fingers; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008348:Manikins; D011312:Pressure; D011446:Prospective Studies; D013933:Thumb