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3503375 
Journal Article 
A vertical two-thumb technique is superior to the two-thumb encircling technique for infant cardiopulmonary resuscitation 
Na, JU; Choi, PC; Lee, HJ; Shin, DH; Han, SK; Cho, JH 
2015 
Yes 
Acta Paediatrica
ISSN: 0803-5253
EISSN: 1651-2227 
104 
2 
e70-e75 
English 
25382371 
WOS:000348731000006 
AIM: The two-thumb encircling (TTE) technique often results in suboptimal cardiac compression and does not meet the requirements of current resuscitation guidelines. We compared this technique with the vertical two-thumb (VTT) technique, our novel modification of the TTE technique.

METHODS: This was a prospective randomised crossover simulation study of out-of-hospital infant cardiopulmonary resuscitation (CPR). Participants who had completed a basic life support course performed 10 cycles of cardiac compressions on a manikin for each technique.

RESULTS: We enrolled 36 medical doctors who had applied for a hospital internship in this study. The VTT generated significantly higher pressure than the TTE and the pressure difference ranged from 26.8 to 62.9 mmHg for each cycle, with a mean difference of 43.5 mmHg (95% CI, 37.8-49.2). The difference in pressure showed a tendency to increase with increasing cycles of cardiac compressions. The participants' heart and respiratory rate was higher with the VTT, but they said that it was easier to perform cardiac compressions with this technique.

CONCLUSION: The VTT technique generated more pressure than the TTE technique in a simulated model of infant out-of-hospital CPR. It can provide an alternative compression technique for effective infant CPR, especially for the rescuers with small hands or a weak grip.