Comparison of a two-finger versus two-thumb method for chest compressions by healthcare providers in an infant mechanical model

Whitelaw, Christine Cappelle; Slywka, Brad; Goldsmith, L. Jane

doi:10.1016/s0300-9572(99)00145-8

Cited by 83 publications

(39 citation statements)

References 6 publications

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“…157 Two techniques have been described: compression with 2 thumbs with the fingers encircling the chest and supporting the back (the 2-thumb technique) or compression with 2 fingers with a second hand supporting the back (the 2-finger technique). Because the 2-thumb technique generates higher blood pressure and coronary perfusion pressure with less rescuer fatigue, the 2 thumb-encircling hands technique is suggested as the preferred method [158][159][160][161][162][163][164][165][166][167][168][169][170][171][172] (Class IIb, LOE C-LD). Because the 2-thumb technique can be continued from the head of the bed while the umbilicus is accessed for insertion of an umbilical catheter, the 2-finger technique is no longer needed.…”

mentioning

confidence: 99%

Part 13: Neonatal Resuscitation

Wyckoff¹,

Aziz²,

Escobedo³

et al. 2015

Pediatrics

265

353

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mentioning

confidence: 99%

Part 13: Neonatal Resuscitation

Wyckoff¹,

Aziz²,

Escobedo³

et al. 2015

Pediatrics

265

353

View full text Add to dashboard Cite

“…Although several studies have recommended the TTHT, even in lone-rescuer CPR [12,13], in one trial the hands-off-time of the TTHT proved to be significantly longer than that of the TFT [12]. Some manikin studies, as well as animal studies, of haemodynamic monitoring in infants showed that the TTHT produced higher systolic and diastolic arterial pressures and more consistent correct depth as compared with the TFT [9,[14][15][16].…”

Section: Discussionmentioning

confidence: 99%

The quality of a newly developed infant chest compression method applied by paramedics: a randomised crossover manikin trial

et al. 2017

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A b s t r a c tBackground: The aetiology of sudden cardiac arrest in infants is different from that in adults, with respiratory failure, sudden infant death syndrome, and drowning being the primary causes in the former. According to the European Resuscitation Council (ERC) and American Heart Association (AHA) recommendations, the quality of chest compressions (CC) is a key element affecting the effectiveness of cardiopulmonary resuscitation (CPR). The current ERC and AHA guidelines recommend the 'two-finger technique' (TFT) or 'two-thumb encircling hands technique' (TTHT) for external CCs during infant CPR. Aim:The aim of the randomised crossover manikin trial was to assess the CC quality during simulated resuscitation in infants performed by paramedics. Methods:A prospective, randomised, crossover, single-centre study was conducted between June and August 2016. The study material consisted of 120 fully trained and licensed paramedics (39 females, 32.5%) with a minimum of five years of professional experience (mean 7.5 ± 4.8 years) in emergency medicine (mean age, 30.5 ± 5.5 years). The participants performed CCs using three techniques: TFT (the rescuer compresses the sternum with the tips of two fingers); TTHT; and the 'new two-thumb technique' (nTTT). The novel method of CCs in an infant consists of using two thumbs directed at the angle of 90 degrees to the chest while closing the fingers of both hands in a fist. Results:The median CC rate when using the TFT, the TTHT, and nTTT methods varied and amounted to 134 min -1 vs. 126 min -1 vs. 114 min -1 , respectively. There was a statistically significant difference in the median CC frequency between TFT and TTHT (p < 0.001), TFT and nTTT (p < 0.001), and between TTHT and nTTT (p < 0.001). The highest percentage of compressions with the frequency recommended by the ERC guidelines (100-120 min -1 ) was achieved by the study participants only with the nTTT. The median CC depth during the TFT was 28 mm (interquartile range [IQR] 27-30 mm) and was significantly lower than in the static . In all scenarios, the correct placement of the CC point was achieved in more than 90% of cases. Conclusions:Our novel infant CC method provides the highest percentage of CCs with the frequency recommended by the ERC guidelines as compared with standard techniques. It also allows optimal CC depth.

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“…[2][3][4]15,16 Two-thumbs encircling hands technique has been found to generate higher systolic and mean blood pressures as compared with two-fingers technique, 2,3,15 although this finding is not universal. 16 Other advantages of two-thumbs encircling hand technique over twofingers technique include better control of depth of compressions, being less tiring when performed for longer duration and suitable for individuals with long finger nails.…”

Section: Discussionmentioning

confidence: 99%

A comparison of two-fingers technique and two-thumbs encircling hands technique of chest compression in neonates

et al. 2011

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Objective: To compare the proportion of correct placements (POCP) between 'two-fingers' and 'two-thumbs' techniques of chest compression among neonates of various gestations.Study Design: Two-fingers and two-thumbs spans of 32 adult rescuers were individually compared with the inter-nipple line to sterno-xiphoid junction distance of 39 neonates. 'Correct placement' was defined if two-fingers/two-thumbs span was equal to or less than the inter-nipple line to sterno-xiphoid junction distance. The POCPs was compared between two-fingers and two-thumbs methods of chest compression by the McNemar test among neonates and their various subgroups.Result: There were a total of 1248 comparisons. The POCPs with two-fingers and two-thumbs techniques were 6.7 and 77% in all neonates, 10.6 and 89.5% in full term and 1.2 and 59% in preterm neonates, respectively (P<0.001).Conclusion: Two-thumbs technique achieved higher POCPs and should be preferred over two-fingers technique among neonates.

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Comparison of a two-finger versus two-thumb method for chest compressions by healthcare providers in an infant mechanical model

Cited by 83 publications

References 6 publications

Part 13: Neonatal Resuscitation

Part 13: Neonatal Resuscitation

The quality of a newly developed infant chest compression method applied by paramedics: a randomised crossover manikin trial

A comparison of two-fingers technique and two-thumbs encircling hands technique of chest compression in neonates

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