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

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 302 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 302 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).