Comparison of standard and alternative methods for chest compressions in a single rescuer infant CPR: A prospective simulation study

OBJECTIVE: The aims of this study were to develop a novel three-finger chest compression technique (pinch technique; PT) and an assistive device chest compression technique (plate-assisted technique; PAT) and compare these techniques with conventional techniques. DESIGN: Prospective, crossover manikin study SETTING: Pediatric emergency department at a tertiary care academic center SUBJECTS: Fifty medical doctors and medical students INTERVENTIONS: Using a manikin, fifty participants performed five different chest compression techniques—two 2-finger techniques (TFT1 and TFT2), two PTs (PT1 and PT2), and the PAT—for 2 minutes with 2 minutes of rest in a randomized sequence. MEASUREMENTS AND MAIN RESULTS: The compression depth (CD), compression rate, recoil, and finger position were recorded. At the study conclusion, each participant completed a 5-point Likert scale-based questionnaire on fatigue, satisfaction and difficulty of performing each technique. The mean CDs were 32.9 mm (TFT1), 30.3 mm (TFT2), 37.3 mm (PT1), 35.0 mm (PT2) and 40.1 mm (PAT) (p<0.001). TFT2 achieved the highest frequency of complete chest recoil, followed by PT1 and TFT1 (88.9%, 86.9%, and 81.4%, respectively, p = 0.003). The highest percentage of correct finger position was achieved by the PAT, followed by the PT1 and PT2 (93.4%, 83.1%, and 80.1%, respectively, p = 0.016). PAT use resulted in higher participant satisfaction, less fatigue, and less difficulty than the other four techniques. CONCLUSION: Our new chest compression methods using three fingers and assistive plates showed better CD results than the conventional 2-finger technique.