Evaluation of new two-thumb chest compression technique for infant CPR performed by novice physicians. A randomized, crossover, manikin trial

Smereka, Jacek; Szarpak, Łukasz; Smereka, Adam; Leung, Steve; Ruetzler, Kurt

doi:10.1016/j.ajem.2016.12.045

Cited by 47 publications

(50 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the case of resuscitation at the floor level and on the forearm of the rescuer, almost 100% of the chest recoil was achieved [28]. Similar results were obtained by Smereka et al [16] in newborn resuscitation. The situation was quite different with resuscitation on a table: full chest recoil was noted only in 1% of the subjects.…”

Section: Discussionsupporting

confidence: 78%

See 1 more Smart Citation

Which position should we take during newborn resuscitation? A prospective, randomised, multicentre simulation trial

et al. 2018

Self Cite

View full text Add to dashboard Cite

A b s t r a c tBackground: Early bystander cardiopulmonary resuscitation (CPR) for cardiac arrest is crucial in the chain of survival. Cardiac arrest in infants is rare, but CPR is also performed in severe bradycardia. European Resuscitation Council and American Heart Association guidelines recommend continuing CPR until the heart muscle is sufficiently oxygenated and regains sufficient contractility and function. The most common and recommended CPR techniques that can be applied in newborns are the two-finger technique and two-thumb technique. Aim:We sought to assess the quality of CPR performed in newborns with the two-finger technique depending on the position of the rescuer during resuscitation. Methods:This was a prospective, randomised, crossover, simulated study. It involved 93 nurses who were required to perform a two-minute CPR using the two-finger technique in three scenarios: (A) with the newborn lying on the floor; (B) on a table; and (C) with the newborn on the rescuer's forearm. The Newborn Tory ® S2210 manikin was used to simulate a neonatal patient in cardiac arrest. The following parameters were measured: chest compression (CC) depth, CC rate, no-flow time, percentage of full release, ventilation rate, and ventilation volume, as well as the number of effective compressions and effective ventilations.Results: Statistical analysis showed significant differences in CC rates between scenarios A and B (p < 0.001) and between scenarios B and C (p = 0.002). Significant differences were also observed between the median CC depth. The median percentage of no-flow-fraction was the highest for scenario A (55%), followed by scenario B (48%), and scenario C (46%). There were significant differences between the values of no-flow-fraction between scenarios A and B (p < 0.001), and between scenarios A and C (p < 0.001). The percentage of chest full releases for scenarios A, B, and C amounted to 94%, 1%, and 92%, respectively. Significant differences in the number of effective CCs between scenarios A and B (p < 0.001) as well as B and C (p < 0.001) were revealed. The median ventilation rate was highest for scenario B (13 × min ). The highest tidal volume was obtained in scenario A (27 mL), and the lowest in scenario C (26 mL). The most effective CPR was performed when resuscitation was carried out on the rescuer's forearm. Conclusions:The quality of CCs in newborns depends on the location of the patient and the rescuer. The optimal form of resuscitation of newborns is resuscitation on the rescuer's forearm.

show abstract

Section: Discussionsupporting

confidence: 78%

“…There are also several modifications of the presented techniques, including the two-thumb technique developed by Smereka et al [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Which position should we take during newborn resuscitation? A prospective, randomised, multicentre simulation trial

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…First, we conducted our study using a manikin model which might limit our external validity in real patients. However, the Laerdal Manikin have been widely used in CPR research, including intraosseous device studies [9, 19]. Manikins do not have medullary cavity therefore did not allow us to confirm “successful” with aspiration of marrow or injection of fluid.…”

Section: Discussionmentioning

confidence: 99%

Comparison of four different intraosseous access devices during simulated pediatric resuscitation. A randomized crossover manikin trial

Bielski¹,

Szarpak

Smereka

et al. 2017

Eur J Pediatr

Self Cite

View full text Add to dashboard Cite

The aim of the study was to compare the success rate, procedure time, and user satisfaction of pediatric NIO™ compared to Pediatric BIG®, EZ-IO®, and Jamshidi intraosseous access devices. This was a randomized, crossover manikin trial with 87 paramedics. The correct location of intraosseous access when using NIO, BIG, EZ-IO, and Jamshidi was varied and was respectively 100, 90, 90, and 90%. The time required to obtain intravascular access (time T1) in the case of NIO, BIG, EZ-IO, and Jamshidi was varied and amounted to 9 s [IQR, 8–12] for NIO, 12 s [IQR, 9–16] for BIG, 13.5 s [IQR, 11–17] for the EZ-IO, and 15 s [IQR, 13–19] for Jamshidi. The paramedics evaluated each device on the subjective ease with which they performed the procedures. The intraosseous device, which proved the easiest to use was NIO, which in the case of CPR received a median rating of 1.5 (IQR, 0.5–1.5) points. Conclusion: Our study found that NIO® is superior to BIG®, EZ-IO®, and Jamshidi. NIO® achieved the highest first attempt success rate. NIO® also required the least time to insert and easiest to operate even by novice users. Further study is needed to test our findings in cadavers or human subjects. Based on our findings, NIO® is a promising intraosseous device for use in pediatric resuscitation. What is Known: • Venous access in acutely ill pediatric patients, such as those undergoing cardiopulmonary resuscitation, is needed for prompt administration of drugs and fluids.• Intraosseous access is recommended by American Heart Association and European Resuscitation council if vascular access is not readily obtainable to prevent delay in treatment. What is New: • This simulated pediatric resuscitation compared performance of four commercially available pediatric intraosseous devices in a manikin model.• NIO® outperformed BIG®, EZ-IO®, and Jamshidi in first attempt success rates and time of procedure among novice users.

show abstract

“…The novel two-thumb technique (NTTT) developed by Smereka et al [18] consists in using two thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist. The alignment of thumbs with the arms allows body strength to be directed downward to the sternum, in contrast to TFT, which mainly relies on finger and hand strength [18,19].…”

Section: Introductionmentioning

confidence: 99%

“…The novel technique has been investigated in several studies in different age groups and study participants as well as in different settings, with the consideration of the resuscitation technique, CC and ventilation ratio, and the time of resuscitation efforts [18,[20][21][22]. The results suggest that NTTT provides several advantages as compared with standard newborn resuscitation techniques, e.g.…”

Section: Introductionmentioning

confidence: 99%

Comparison of two infant chest compression techniques during simulated newborn cardiopulmonary resuscitation performed by a single rescuer: A randomized, crossover multicenter trial

2020

Self Cite

View full text Add to dashboard Cite

show abstract

Evaluation of new two-thumb chest compression technique for infant CPR performed by novice physicians. A randomized, crossover, manikin trial

Cited by 47 publications

References 28 publications

Which position should we take during newborn resuscitation? A prospective, randomised, multicentre simulation trial

Which position should we take during newborn resuscitation? A prospective, randomised, multicentre simulation trial

Comparison of four different intraosseous access devices during simulated pediatric resuscitation. A randomized crossover manikin trial

Comparison of two infant chest compression techniques during simulated newborn cardiopulmonary resuscitation performed by a single rescuer: A randomized, crossover multicenter trial

Contact Info

Product

Resources

About