J Korean Med Sci.  2016 Jun;31(6):997-1002. 10.3346/jkms.2016.31.6.997.

Which Fingers Should We Perform Two-Finger Chest Compression Technique with When Performing Cardiopulmonary Resuscitation on an Infant in Cardiac Arrest?

• Kim YS
• Oh JH
• Kim CW
• Kim SE
• Lee DH
• Hong JY

• KMID: 2373712
• DOI: http://doi.org/10.3346/jkms.2016.31.6.997

Abstract

This study compared the effectiveness two-finger chest compression technique (TFCC) performed using the right vs. left hand and the index-middle vs. middle-ring fingers. Four different finger/hand combinations were tested randomly in 30 healthcare providers performing TFCC (Test 1: the right index-middle fingers; Test 2: the left index-middle fingers; Test 3: the right middle-ring fingers; Test 4: the left middle-ring fingers) using two cross-over trials. The "patient" was a 3-month-old-infant-sized manikin. Each experiment consisted of cardiopulmonary resuscitation (CPR) consisting of 2 minutes of 30:2 compression: ventilation performed by one rescuer on a manikin lying on the floor as if in cardiac arrest. Ventilations were performed using the mouth-to-mouth method. Compression and ventilation data were collected during the tests. The mean compression depth (MCD) was significantly greater in TFCC performed with the index-middle fingers than with the middle-ring fingers regardless of the hand (95% confidence intervals; right hand: 37.8-40.2 vs. 35.2-38.6 mm, P = 0.002; left hand: 36.9-39.2 vs. 35.5-38.1 mm, P = 0.003). A deeper MCD was achieved with the index-middle fingers of the right versus the left hand (P = 0.004). The ratio of sufficiently deep compressions showed the same patterns. There were no significant differences in the other data. The best performance of TFCC in simulated 30:2 compression: ventilation CPR performed by one rescuer on an infant in cardiac arrest lying on the floor was obtained using the index-middle fingers of the right hand. Clinical Trial Registry at the Clinical Research Information Service (KCT0001515).

Keyword

Cardiopulmonary Resuscitation; Infant; Fingers; Hand

MeSH Terms

Adult
Cardiopulmonary Resuscitation/*methods
Cross-Over Studies
Female
*Fingers
Hand
Heart Arrest/*therapy
Humans
Infant
Male
Manikins
Models, Cardiovascular
Thorax/physiology
Young Adult

Figure

• 

  Fig. 1 Study flow diagram. Two cross-over trials (A and B) including four tests (1 to 4) were conducted with random order. TFCC, Two-finger chest compression technique.

• 

  Fig. 2 Postures of the two-finger chest compression in the tests. Test 1: Two-finger chest compression with the index-middle fingers of the right hand. Test 2: Two-finger chest compression with the index-middle fingers of the left hand. Test 3: Two-finger chest compression with the middle-ring fingers of the right hand. Test 4: Two-finger chest compression with the middle-ring fingers of the left hand. The test 1 and 3 were conducted on the right side of the manikin and the test 2 and 4 were conducted on the left side of the manikin.

• 

  Fig. 3 Comparisons of mean chest compression depths. The compression depths of the two-finger chest compression techniques were deepest with right index-middle fingers.

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