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Do chest compressions during simulated infant CPR comply with international recommendations?

Martin, Philip Stephen, Kemp, Alison Mary, Theobald, Peter, Maguire, Sabine Ann and Jones, Michael David 2013. Do chest compressions during simulated infant CPR comply with international recommendations? Archives of Disease in Childhood 98 , pp. 576-581. 10.1136/archdischild-2012-302583

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Abstract

Background: Morbidity and mortality remain high following infant cardiac arrest. Optimal cardiopulmonary resuscitation (CPR) is therefore imperative. Objective: Comparison of two-thumb (TT) and two-finger (TF) infant chest compression technique compliance with international recommendations. Design: Randomised cross-over experimental study. Methods: Twenty-two certified Advanced Paediatric Life Support (APLS) instructors performed 2 min continuous TT and TF chest compressions on an instrumented infant CPR manikin. Compression depth (CD), release force (RF), compression rate (CR) and duty cycles (DCs) were recorded. Quality indices were developed to calculate the proportion of compressions that complied with internationally recommended targets, and an overall quality index was used to calculate the proportion that complied with all four targets. Results: Mean CD was 33 mm and 26 mm (p<0.001; target ≥36.7 mm), mean RF was 0.8 kg and 0.2 kg (p<0.001; target <2.5 kg), mean CR was 128/min and 131/min (p=0.052; target 100–120/min) and mean DCs was 61% and 53% (p<0.001; target 30–50%) for the TT and TF techniques, respectively. With the exception of RF, the majority of compressions failed to comply with targets. The TT technique improved median CD compliance (6% vs 0% (p<0.001)), while the TF technique improved median DC compliance (23% vs 0% (p<0.001)). Overall compliance with all four targets was <1% for both techniques (p=0.14). Conclusions: Compliance of APLS instructors with current international recommendations during simulated infant CPR is poor. The TT technique provided improved CD compliance, while the TF technique provided superior DC compliance. If this reflects current clinical practice, optimisation of performance to achieve international recommendations during infant CPR is called for.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Engineering
Medicine
Subjects: R Medicine > RJ Pediatrics
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
T Technology > TJ Mechanical engineering and machinery
Publisher: BMJ Publishing Group
ISSN: 0003-9888
Last Modified: 12 Sep 2018 21:38
URI: http://orca.cf.ac.uk/id/eprint/43095

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