The superiority of the two-thumb over the two-finger technique for single-rescuer infant cardiopulmonary resuscitation

Abstract

ObjectivesThe two-finger technique (TFT) using the index-middle fingers of the right hand (TFT-R23) was recently confirmed to produce deeper chest compression depth (CCD) compared with the TFT using any other fingers. This study was carried out to confirm whether the TFT-R23 would be as effective as the two-thumb technique (TTT). In addition, individual finger strengths were measured to identify the reasons why the TTT and TFT-R23 produced deeper CCD than any other methods.MethodsThis prospective randomized cross-over trial compared TTT with TFT-R23. A total of 37 doctors conducted 2min single-rescuer cardiopulmonary resuscitation using TTT and TFT-R23 in a random order using a 3-month-old sized infant manikin laid on the floor. The chest compression to ventilation ratio was set to 15:2. In addition, finger strengths were measured using a pinch meter.ResultsThe actual CCD of the TTT was significantly deeper than that of the TFT-R23 (41.31.3 vs. 39.8 +/- 1.5mm, P<0.001). Although the hands-off time of the TTT was significantly longer than that of the TFT-R23 (55.6 +/- 5.7 vs. 53.6 +/- 5.8s, P=0.002), the mean difference was only 2.0 +/- 3.7s (95% confidence interval: 0.755-3.245). The finger strength of the TTT was significantly higher than that of TFT-R23 (23.8 +/- 10.1 vs. 13.7 +/- 5.1kg, P<0.001).ConclusionThe TTT produced deeper CCD compared with that of the TFT-R23 because the finger strength of the TTT was significantly higher than that of the TFT-R23.