title: Which Fingers Should We Perform Two-Finger Chest Compression Technique with When Performing Cardiopulmonary Resuscitation on an Infant in Cardiac Arrest?
abstract: This study compared the effectiveness two-finger chest compression technique (TFCC) performed using the right vs. left hand and the index-middle vs. middle-ring fingers. Four different finger/hand combinations were tested randomly in 30 healthcare providers performing TFCC (Test 1: the right index-middle fingers; Test 2: the left index-middle fingers; Test 3: the right middle-ring fingers; Test 4: the left middle-ring fingers) using two cross-over trials. The "patient" was a 3-month-old-infant-sized manikin. Each experiment consisted of cardiopulmonary resuscitation (CPR) consisting of 2 minutes of 30:2 compression: ventilation performed by one rescuer on a manikin lying on the floor as if in cardiac arrest. Ventilations were performed using the mouth-to-mouth method. Compression and ventilation data were collected during the tests. The mean compression depth (MCD) was significantly greater in TFCC performed with the index-middle fingers than with the middle-ring fingers regardless of the hand (95% confidence intervals; right hand: 37.8-40.2 vs. 35.2-38.6 mm, P = 0.002; left hand: 36.9-39.2 vs. 35.5-38.1 mm, P = 0.003). A deeper MCD was achieved with the index-middle fingers of the right versus the left hand (P = 0.004). The ratio of sufficiently deep compressions showed the same patterns. There were no significant differences in the other data. The best performance of TFCC in simulated 30:2 compression: ventilation CPR performed by one rescuer on an infant in cardiac arrest lying on the floor was obtained using the index-middle fingers of the right hand. Clinical Trial Registry at the Clinical Research Information Service (KCT0001515).
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Korea .
authors.forename: Young Sinn
authors.identifier: 0000-0002-8408-8163
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Korea .
authors.forename: Je Hyeok
authors.identifier: 0000-0002-5211-3838
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Korea .
authors.forename: Chan Woong
authors.identifier: 0000-0001-7821-8980
authors.initials: CW
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Korea .
authors.forename: Sung Eun
authors.identifier: 0000-0003-2121-6073
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Korea .
authors.forename: Dong Hoon
authors.identifier: 0000-0003-4306-8649
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Korea .
authors.forename: Jun Young
authors.identifier: 0000-0002-6939-5755
authors.initials: JY
authors.lastname: Hong
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D005385:Fingers; D006225:Hand; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008348:Manikins; D008955:Models, Cardiovascular; D013909:Thorax / Q000502:physiology; D055815:Young Adult
keywords: Cardiopulmonary Resuscitation; Fingers; Hand; Infant