Is there any alternative to standard chest compression techniques in infants? A randomized manikin trial of the new “2-thumb-fist” option

Is there any alternative to standard chest compression techniques in infants? A randomized... AbstractBackground:Pediatric cardiac arrest is a fatal emergent condition that is associated with high mortality, permanent neurological injury, and is a socioeconomic burden at both the individual and national levels. The aim of this study was to test in an infant manikin a new chest compression (CC) technique (“2 thumbs-fist” or nTTT) in comparison with standard 2-finger (TFT) and 2-thumb-encircling hands techniques (TTEHT).Methods:This was prospective, randomized, crossover manikin study. Sixty-three nurses who performed a randomized sequence of 2-minute continuous CC with the 3 techniques in random order. Simulated systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and pulse pressures (PP, SBP–DBP) in mm Hg were measured.Results:The nTTT resulted in a higher median SBP value (69 [IQR, 63–74] mm Hg) than TTEHT (41.5 [IQR, 39–42] mm Hg), (P < .001) and TFT (26.5 [IQR, 25.5–29] mm Hg), (P <.001). The simulated median value of DBP was 20 (IQR, 19–20) mm Hg with nTTT, 18 (IQR, 17–19) mm Hg with TTEHT and 23.5 (IQR, 22–25.5) mm Hg with TFT. DBP was significantly higher with TFT than with TTEHT (P <.001), as well as with TTEHT than nTTT (P <.001). Median values of simulated MAP were 37 (IQR, 34.5–38) mm Hg with nTTT, 26 (IQR, 25–26) mm Hg with TTEHT and 24.5 (IQR,23.5–26.5) mm Hg with TFT. A statistically significant difference was noticed between nTTT and TFT (P <.001), nTTT and TTEHT (P <.001), and between TTEHT and TFT (P <.001). Sixty-one subjects (96.8%) preferred the nTTT over the 2 standard methods.Conclusions:The new nTTT technique achieved higher SBP and MAP compared to the standard CC techniques in our infant manikin model. nTTT appears to be a suitable alternative or complementary to the TFT and TTEHT. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Medicine Wolters Kluwer Health

Is there any alternative to standard chest compression techniques in infants? A randomized manikin trial of the new “2-thumb-fist” option

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Publisher
Wolters Kluwer
Copyright
Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.
ISSN
0025-7974
eISSN
1536-5964
D.O.I.
10.1097/MD.0000000000009386
Publisher site
See Article on Publisher Site

Abstract

AbstractBackground:Pediatric cardiac arrest is a fatal emergent condition that is associated with high mortality, permanent neurological injury, and is a socioeconomic burden at both the individual and national levels. The aim of this study was to test in an infant manikin a new chest compression (CC) technique (“2 thumbs-fist” or nTTT) in comparison with standard 2-finger (TFT) and 2-thumb-encircling hands techniques (TTEHT).Methods:This was prospective, randomized, crossover manikin study. Sixty-three nurses who performed a randomized sequence of 2-minute continuous CC with the 3 techniques in random order. Simulated systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and pulse pressures (PP, SBP–DBP) in mm Hg were measured.Results:The nTTT resulted in a higher median SBP value (69 [IQR, 63–74] mm Hg) than TTEHT (41.5 [IQR, 39–42] mm Hg), (P < .001) and TFT (26.5 [IQR, 25.5–29] mm Hg), (P <.001). The simulated median value of DBP was 20 (IQR, 19–20) mm Hg with nTTT, 18 (IQR, 17–19) mm Hg with TTEHT and 23.5 (IQR, 22–25.5) mm Hg with TFT. DBP was significantly higher with TFT than with TTEHT (P <.001), as well as with TTEHT than nTTT (P <.001). Median values of simulated MAP were 37 (IQR, 34.5–38) mm Hg with nTTT, 26 (IQR, 25–26) mm Hg with TTEHT and 24.5 (IQR,23.5–26.5) mm Hg with TFT. A statistically significant difference was noticed between nTTT and TFT (P <.001), nTTT and TTEHT (P <.001), and between TTEHT and TFT (P <.001). Sixty-one subjects (96.8%) preferred the nTTT over the 2 standard methods.Conclusions:The new nTTT technique achieved higher SBP and MAP compared to the standard CC techniques in our infant manikin model. nTTT appears to be a suitable alternative or complementary to the TFT and TTEHT.

Journal

MedicineWolters Kluwer Health

Published: Feb 1, 2018

References

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