Two-Thumb Encircling Technique Over the Head of Patients in the Setting of Lone Rescuer Infant CPR Occurred During Ambulance Transfer: A Crossover Simulation Study.
OBJECTIVE
The purpose of this study was to determine if the over-the-head 2-thumb encircling technique (OTTT) provides better overall quality of cardiopulmonary resuscitation compared with conventional 2-finger technique (TFT) for a lone rescuer in the setting of infant cardiac arrest in ambulance.


METHODS
Fifty medical emergency service students were voluntarily recruited to perform lone rescuer infant cardiopulmonary resuscitation for 2 minutes on a manikin simulating a 3-month-old baby in an ambulance. Participants who performed OTTT sat over the head of manikins to compress the chest using a 2-thumb encircling technique and provide bag-valve mask ventilations, whereas those who performed TFT sat at the side of the manikins to compress using 2-fingers and provide pocket-mask ventilations.


RESULTS
Mean hands-off time was not significantly different between OTTT and TFT (7.6 ± 1.1 seconds vs 7.9 ± 1.3 seconds, P = 0.885). Over-the-head 2-thumb encircling technique resulted in greater depth of compression (42.6 ± 1.4 mm vs 41.0 ± 1.4 mm, P < 0.001) and faster rate of compressions (114.4 ± 8.0 per minute vs 112.2 ± 8.2 per minute, P = 0.019) than TFT. Over-the-head 2-thumb encircling technique resulted in a smaller fatigue score than TFT (1.7 ± 1.5 vs 2.5 ± 1.6, P < 0.001). In addition, subjects reported that compression, ventilation, and changing compression to ventilation were easier in OTTT than in TFT.


CONCLUSIONS
The use of OTTT may be a suitable alternative to TFT in the setting of cardiac arrest of infants during ambulance transfer.
From the *Department of Emergency Medicine, School of Medicine, Hallym University, Seoul; and †Department of Emergency Medical Service, Namseoul University, Cheonan City, Choongnam, Republic of Korea.
Choong Hyun
CH
Jo
Gyu Chong
GC
Cho
Chang Hee
CH
Lee
D000552:Ambulances; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008348:Manikins; D011446:Prospective Studies; D055815:Young Adult