Optimizing Pediatric Chest Compressions: A Randomized Crossover Simulation Trial of Over-the-Head vs. Lateral Techniques.
Pediatric Reports · 2025-04-08 · Randomised trial
Abstract
BACKGROUND/OBJECTIVES: Pediatric cardiac arrest poses considerable obstacles, with survival rates markedly inferior to those of adults. Effective chest compressions are essential for enhancing outcomes; nevertheless, the ideal rescuer attitude is still ambiguous. This study sought to compare the efficacy of lateral (LAT) and over-the-head (OTH) chest compression techniques in pediatric cardiopulmonary resuscitation (CPR) and to ascertain whether OTH presents a viable alternative to the conventional LAT method by assessing compression quality, rescuer fatigue, and ergonomics. METHODS: A randomized crossover simulation study was conducted in a high-fidelity medical simulation facility. Thirty-five medical students executed 2 min cycles of chest compressions with both LAT and OTH techniques, interspersed with a 15 min rest period between sessions. RESULTS: OTH showed a tendency for enhanced overall performance (72.94 vs. 64.46; p = 0.08), while the differences lacked statistical significance. The compression rate was somewhat elevated with OTH (116.94 compared to 114.57; p = 0.31). We assessed LAT as somewhat less challenging (4.37 vs. 3.91; p = 0.17) and found less fatigue (4.83 vs. 4.40; p = 0.24). Male rescuers and individuals with elevated BMI attained larger compression depths. Age was negatively connected with the ease and efficiency of compressions. CONCLUSIONS: Although no statistically significant differences were detected, OTH demonstrated potential for enhanced performance. The anthropometrics of rescuers affected the quality of CPR, highlighting the necessity for tailored training methods. Future investigations should examine the long-term viability of OTH in clinical and pre-hospital environments.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Related articles
- Does heart rate variability predict and improve performance in pediatric CPR?-a simulation study. (BMC Emerg Med, 2025)
- Dominant vs. Non-Dominant Hand in Pediatric Cardiopulmonary Resuscitation: A Randomized Crossover Simulation Trial (Eurasian Journal of Emergency Medicine, 2025)
- Comparison of two mechanical intraosseous infusion devices: a pilot, randomized crossover trial. (Resuscitation, 2009)
- Simulation training with structured debriefing improves residents' pediatric disaster triage performance. (Prehosp Disaster Med, 2012)
- Temporal trends in chest compression quality during a metronome-guided CPR simulation: a secondary analysis of the RITMICO study. (Resusc Plus, 2026)
- Comparisons of the vertical one-handed chest compressions according to the rescuer's handedness. (Am J Emerg Med, 2024)