PT  - JOURNAL ARTICLE
AU  - Jeffrey L Pellegrino
AU  - David Bogumil
AU  - Jonathan L Epstein
AU  - Rita V Burke
TI  - Two-thumb-encircling advantageous for lay responder infant CPR: a randomised manikin study
AID  - 10.1136/archdischild-2018-314893
DP  - 2019 Jun 01
TA  - Archives of Disease in Childhood
PG  - 530--534
VI  - 104
IP  - 6
4099  - http://adc.bmj.com/content/104/6/530.short
4100  - http://adc.bmj.com/content/104/6/530.full
SO  - Arch Dis Child2019 Jun 01; 104
AB  - Objective Paediatric health providers and educators influence infant mortality through advocacy and training within families and communities. This research sought to establish the efficacy and training of two-finger versus two-thumb-encircling techniques for lone responder infant chest compressions with ventilations in initially trained infant caregivers.Design This is a randomised, cross-over educational intervention assessed on instrumented manikins using the 2015 guideline measures of quality infant cardiopulmonary resuscitation (CPR). Additional subjective data on the experience were collected through self-reporting.Setting Non-healthcare community organisations and secondary school classrooms.Participants Fourteen years or older, fluent in English and had not taken infant CPR in the last 5 years.Interventions Groups of eight participants were randomised to learn one technique, practised and then tested for 8 min. After a 30 min rest, the group repeated the process using the other technique.Main outcome measures Mean chest compression depth and rate, compression fraction, and correct hand position; tiredness and pain as reported by the caregiver.Results The two-thumb-encircling technique achieved a deeper mean compression depth over the 8 min period (2.0 mm, p<0.01), closer to the minimum recommendation of 40 mm; the two-finger technique achieved higher percentages of compression fraction and complete recoil. Caregivers preferred the two-thumb technique (64%), and of these 70% had long fingernails.Conclusions The two-thumb-encircling technique improved compression depth, over an 8 min scenario, and was preferred by caregivers. This adds to the existing literature on the advantages of two-thumb-encircling as a technique for lone and team infant CPR, which counters current guidelines.