Two-Thumb Encircling Technique With a Novel Compression Assist Device Provides Safe and Effective Chest Compressions in Infants

OBJECTIVE

Currently, 2-thumb encircling technique is recommended in 2-rescuer infant cardiopulmonary resuscitation (CPR). However, many complications can occur during CPR. Therefore, we developed a novel compression assist device (Reheart) that can reduce chest compression area and determined whether using our device provides better compression quality.

METHODS

A novel compression assist device consists of 2 parts. The upper part was designed to put 2 thumbs together in the thumb sleeves, and the lower part was designed based on a circular rubber plate with a 2.0-cm diameter to confine compression area. Infant manikin CPR simulations using the 2-thumb encircling technique with Reheart and without Reheart were sequentially performed by participants in randomized crossover fashion.

RESULTS

A total of 32 health care providers were included. The average age of the participants was 30.2 ± 3.5 years, and 21 participants (65.6%) were male. The accuracy in the Reheart group was better than that in the conventional group (proportion of compression on target area, 52.5% ± 13.2% vs 35.4% ± 17.6%; P < 0.001). The difference in the rates of chest compressions between the 2 groups was not significant (119.6 ± 14.4 vs 120.7 ± 14.0 compressions/min, P = 0.59). The depth of chest compressions was also not significantly different between the 2 groups (34.5 mm [33.6-34.9 mm] vs 34.2 mm [33.0-34.9 mm], P = 0.32).

CONCLUSIONS

Our new compression assist device can help provide safe and effective chest compressions during 2-rescuer infant CPR.

Design and validation of a tool for the evaluation of the quality of Cardiopulmonary Resuscitation: SIEVCA-CPR 2.0®

INTRODUCTION

Currently, no system completely evaluates the quality of cardio pulmonary resusciation.

METHODS

A cross-sectional, prospective, longitudinal study using Delphi methodology was performed in three phases: preparatory, consultation and consensus. The validation was made by a prospective longitudinal study using the tool in the evaluation of 11 videos to determine the intra-class correlation coefficient (ICC) and the intra-subject (ICC-Initial), the latter repeated at four weeks (ICC-Final). We have determined intra-subject ICC: Initial-Final. This last result has been compared with a gold-standard value.

RESULTS

After the first phase, a 28-items list has been developed. In the second phase: ICC-Initial = 0.727 (p < .001), 95% CI (0.625, 0.801), ICC-Final = 0.860 (p < .001), 95% CI (0.807; 0.898) and ICC Initial-Final = 0.880 (p < .001), 95% CI (0.835; 0.913). Finally, an online tool has been developed (SIEVCA 2.0).

CONCLUSION

The designed tool presents good reliability in the assessment of cardio pulmonary resuscitation and it is useful in different fields and scenarios.

A comparison between the two methods of chest compression in infant and neonatal resuscitation. A review according to 2010 CPR guidelines

AIM

The quality of chest compression (CC) delivered during neonatal and infant cardiopulmonary resuscitation (CPR) is identified as the most important factor to achieve the increase of survival rate without major neurological deficit to the patients. The objective of the study was to systematically review all the available studies that have compared the two different techniques of hand placement on infants and neonatal resuscitation, from 2010 to 2015 and to highlight which method is more effective.

METHODS

A review of the literature using a variety of medical databases, including Cochrane, MEDLINE, and SCOPUS electronic databases. The following MeSH terms were used in the search: infant, neonatal, CPR, CC, two-thumb (TT) technique/method, two-finger (TF) technique/method, rescuer fatigue, thumb/finger position/placement, as well as combinations of these.

RESULTS

Ten studies met the inclusion criteria; nine observational studies and a randomized controlled trial. All providers performed either continuous TF or TT technique CCs and the majority of CPR performance was taken place in infant trainer manikin.

CONCLUSIONS

The majority of the studies suggest the TT method as the more useful for infants and neonatal resuscitation than the TF.