The superiority of the two-thumb over the two-finger technique for single-rescuer infant cardiopulmonary resuscitation.
OBJECTIVE
The two-finger technique (TFT) using the index-middle fingers of the right hand (TFT-R23) was recently confirmed to produce deeper chest compression depth (CCD) compared with the TFT using any other fingers. This study was carried out to confirm whether the TFT-R23 would be as effective as the two-thumb technique (TTT). In addition, individual finger strengths were measured to identify the reasons why the TTT and TFT-R23 produced deeper CCD than any other methods.


METHODS
This prospective randomized cross-over trial compared TTT with TFT-R23. A total of 37 doctors conducted 2 min single-rescuer cardiopulmonary resuscitation using TTT and TFT-R23 in a random order using a 3-month-old sized infant manikin laid on the floor. The chest compression to ventilation ratio was set to 15 : 2. In addition, finger strengths were measured using a pinch meter.


RESULTS
The actual CCD of the TTT was significantly deeper than that of the TFT-R23 (41.3±1.3 vs. 39.8±1.5 mm, P<0.001). Although the hands-off time of the TTT was significantly longer than that of the TFT-R23 (55.6±5.7 vs. 53.6±5.8 s, P=0.002), the mean difference was only 2.0±3.7 s (95% confidence interval: 0.755-3.245). The finger strength of the TTT was significantly higher than that of TFT-R23 (23.8±10.1 vs. 13.7±5.1 kg, P<0.001).


CONCLUSIONS
The TTT produced deeper CCD compared with that of the TFT-R23 because the finger strength of the TTT was significantly higher than that of the TFT-R23.
Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center.
Sang Yoon
SY
Lee
Department of Emergency Medicine.
Jun Young
JY
Hong
Department of Emergency Medicine.
Je Hyeok
JH
Oh
Department of Physical Medicine and Rehabilitation, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
Sun-Han
SH
Son
D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D035641:Chest Wall Oscillation / Q000379:methods*; D018592:Cross-Over Studies; D005385:Fingers; D018737:Hand Strength / Q000502:physiology*; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007223:Infant; D008348:Manikins; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity