Does a more "physiological" infant manikin design effect chest compression quality and create a potential for thoracic over-compression during simulated infant CPR?
Resuscitation · 2012-10-30 · Randomised trial
Abstract
Poor survivability following infant cardiac arrest has been attributed to poor quality chest compressions. Current infant CPR manikins, used to teach and revise chest compression technique, appear to limit maximum compression depths (CDmax) to 40 mm. This study evaluates the effect of a more "physiological" CDmax on chest compression quality and assesses whether proposed injury risk thresholds are exceeded by thoracic over-compression. A commercially available infant CPR manikin was instrumented to record chest compressions and modified to enable compression depths of 40 mm (original; CDmax40) and 56 mm (the internal thoracic depth of a three-month-old male infant; CDmax56). Forty certified European Paediatric Life Support instructors performed two-thumb (TT) and two-finger (TF) chest compressions at both CDmax settings in a randomised crossover sequence. Chest compression performance was compared to recommended targets and compression depths were compared to a proposed thoracic over-compression threshold. Compressions achieved greater depths across both techniques using the CDmax56, with 44% of TT and 34% of TF chest compressions achieving the recommended targets. Compressions achieved depths that exceeded the proposed intra-thoracic injury threshold. The modified manikin (CDmax56) improved duty cycle compliance; however, the chest compression rate was consistently too high. Overall, the quality of chest compressions remained poor in comparison with internationally recommended guidelines. This data indicates that the use of a modified manikin (CDmax56) as a training aid may encourage resuscitators to habitually perform deeper chest compressions, whilst avoiding thoracic over-compression and thereby improving current CPR quality. Future work will evaluate resuscitator performance within a more realistic, simulated CPR environment.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Related articles
- Analysis of the adequacy of infant cardiopulmonary resuscitation according to chest compression technique based on the 2020 AHA guidelines (Signa Vitae, 2022)
- Two-Thumb Technique Is Superior to Two-Finger Technique in Cardiopulmonary Resuscitation of Simulated Out-of-Hospital Cardiac Arrest in Infants. (J Am Heart Assoc, 2021)
- A Novel Method of Newborn Chest Compression: A Randomized Crossover Simulation Study. (Front Pediatr, 2018)
- 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. (Pediatr Emerg Care, 2017)
- Comparison of overlapping (OP) and adjacent thumb positions (AP) for cardiac compressions using the encircling method in infants. (Emerg Med J, 2013)
- New method of chest compression for infants in a single rescuer situation: thumb-index finger technique. (J Med Dent Sci, 2011)