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Out-of-hospital cardiopulmonary resuscitation strategies using one-handed chest compression technique for children suffering a cardiac arrest

Jung, Gun Hee; Oh, Je Hyeok; Kim, Chan Woong; Kim, Sung Eun; Lee, Dong Hoon

European Journal of Emergency Medicine: August 2017 - Volume 24 - Issue 4 - p 255–261
doi: 10.1097/MEJ.0000000000000350

Objective We evaluated the decrease in chest compression depth during 30 : 2 compression-to-ventilation ratio one-handed chest compression (OHCC) in an out-of-hospital pediatric arrest setting, and whether switching hands every other cycle could maintain compression depth.

Methods A 5-year-old child-sized manikin was used, and 50 medical students participated in the present study. First, the participants performed 5 min OHCC with a 30 : 2 compression-to-ventilation ratio on the floor (baseline test). Second, the compression technique was changed from the OHCC to the two-handed chest compression when they became subjectively fatigued (test 1). Third, the compression hand was alternated every other cycle (test 2). Average compression depth (ACD) data were recorded using an accelerometer device.

Results ACD changed significantly during the baseline test (0–1 min: 44.5±5.3 mm, 1–2 min: 43.7±6.1 mm, 2–3 min: 43.4±6.5 mm, 3–4 min: 43.2±6.5 mm, and 4–5 min: 42.3±6.5 mm, P=0.012). However, no significant differences were observed during test 1 or test 2. The baseline ACD value for the 4–5-min interval [95% confidence interval (CI), 40.5–44.2 mm] was significantly lower than those in test 1 (95% CI, 43.0–45.9 mm, P=0.004) and test 2 (95% CI, 42.4–45.9 mm, P=0.004). No differences in the ACDs at any interval were observed between test 1 and test 2.

Conclusion Compression depth decreased significantly after 4 min during 30 : 2 ratio OHCC. However, it was maintained by changing from the OHCC to the two-handed chest compression or by alternating compression hands every other cycle.

Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea

Trial registration: Clinical Research Information Service (KCT0001403).

Correspondence to Je Hyeok Oh, MD, Department of Emergency Medicine, College of Medicine, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea Tel: +82 2 6299 1820; fax: +82 2 6299 2558; e-mail:

Received July 14, 2015

Accepted October 27, 2015

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