Which Structures does a Rescuer compress in One Rescuer Cardiopulmonary Resuscitation for Infant?

ABSTRACT

PURPOSE: We studied which structures were compressed in 1 rescuer cardiopulmonary resuscitation (CPR) in order to determine the optimal compression site on infants. METHODS: Charts and multidirectional computed tomography of infants who presented in the hospitals from March, 2004 to March, 2009 were reviewed retrospectively. We measured the length of the sternum (Stotal), the index finger` s mark (L1) and the two fingers` mark (L2) that were located on the sternum during one rescuer CPR simulation. We studied those structures located at the following points: the lower half of the sternum (Stotal/2), the sternum at the inter-nipple line (Xn), the point of maximal anterior-posterior heart diameter (Xm), and the lower margin of L1 and L2 from Stotal/2, Xn, Xm. RESULTS: Of 75 enrolled infants, Stotal was 5.68+/-2.00 cm; Xn was 2.11+/-1.47 cm; Xm was 1.43+/-1.18 cm; L1 was 1.25+/- 0.21 cm; L2 was 2.88=/-0.33 cm; the ratio of Xm to Stotal was 0.24+/-0.19. 16(21.3%) had ascending aorta, 31(41.3%) had aortic root, and 14(18.7%) had a left ventricular outflow tract in Stotal/2. 14(18.7%) had aortic root, 35(46.7%) had left ventricular outflow tract in Xn. All had left ventricle in the Xm. 12(16.0%) had liver in the lower margin of L1 from Xm. All had liver in the lower margin of L2 from Xm. CONCLUSION: We knew that we had compressed the aortic root, left ventricular outflow tract as we complied with the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. However, the left ventricle was located at the lower quarter of the sternum.