A novel CPR-assist device vs. established chest compression techniques in infant CPR: A manikin study

Chia-Lung Kao; Jui-Yi Tsou; Ming-Yuan Hong; Chih-Jan Chang; Yi-Fang Tu; Shao-Peng Huang; Fong-Chin Su; Chih-Hsien Chi

doi:10.1016/j.ajem.2023.12.002

A novel CPR-assist device vs. established chest compression techniques in infant CPR: A manikin study

Am J Emerg Med. 2024 Mar:77:81-86. doi: 10.1016/j.ajem.2023.12.002. Epub 2023 Dec 9.

Authors

Chia-Lung Kao¹, Jui-Yi Tsou², Ming-Yuan Hong¹, Chih-Jan Chang¹, Yi-Fang Tu³, Shao-Peng Huang¹, Fong-Chin Su⁴, Chih-Hsien Chi⁵

Affiliations

¹ Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.
³ Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine.
⁴ Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Taiwan Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
⁵ Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Taiwan Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan. Electronic address: chich@mail.ncku.edu.tw.

PMID: 38118386
DOI: 10.1016/j.ajem.2023.12.002

Abstract

Introduction: Guidelines for infant CPR recommend the two-thumb encircling hands technique (TTT) and the two-finger technique (TFT) for chest compression. Some devices have been designed to assist with infant CPR, but are often not readily available. Syringe plungers may serve as an alternative infant CPR assist device given their availability in most hospitals. In this study, we aimed to determine whether CPR using a syringe plunger could improve CPR quality measurements on the Resusci-Baby manikin compared with traditional methods of infant CPR.

Methods: Compression area with a diameter of 1 to 2 cm is recommended in previous infant CPR device researches. In this is a randomized crossover manikin study, we examined the efficacy of the Syringe Plunger Technique (SPT) which uses the plunger of the 20 ml syringe with a 2 cm diameter flat piston, commonly available in hospital, for infant External Chest Compressions (ECC). Participants performed TTT, TFT and SPT ECC on Resusci® Baby QCPR® according to 2020 BLS guidelines.

Results: Sixty healthcare providers participated in this project. The median (IQR) ECC depths in the TTT, TFT and SPT in the first minute were 41 mm (40-42), 40 mm (38-41) and 40 mm (39-41), respectively, with p < 0.001. The median (IQR) ECC recoil in the TTT, TFT and SPT groups in the first minute was 15% (1-93), 64% (18-96) and 53% (8-95), respectively, with p = 0.003. The result in the second minute had similar findings. The SPT had the best QCPR score and less fatigue.

Conclusion: The performance of chest compression depth and re-rebound ratio was statistically different among the three groups. TTT has good ECC depth and depth accuracy but poor recoil. TFT is the complete opposite. SPT can achieve a depth close to TTT and has a good recoil performance as TFT. Regarding comprehensive performance, SPT obtains the highest QCPR score, and SPT is also less fatigued. SPT may be an effective alternative technique for infant CPR.

Keywords: Chest compression; Infant resuscitation; Manikin; Novel technique; Syringe plunger.

Publication types

Randomized Controlled Trial

MeSH terms

Cardiopulmonary Resuscitation* / methods
Cross-Over Studies
Fatigue
Fingers
Humans
Infant
Manikins
Thorax
Thumb