European Journal of Pediatrics

, Volume 178, Issue 10, pp 1529–1535 | Cite as

Two new chest compression methods might challenge the standard in a simulated infant model

  • Emilio Rodriguez-RuizEmail author
  • Ainhoa Martínez-Puga
  • Aida Carballo-Fazanes
  • Cristian Abelairas-Gómez
  • Antonio Rodríguez-Nuñez
Original Article


Paediatric cardiorespiratory arrest is a rare event that requires a fast, quality intervention. High-quality chest compressions are an essential prognostic factor. The aim of this prospective, randomized and crossover study in infant manikin 2-min cardiorespiratory resuscitation scenario is to quantitatively compare the quality of the currently recommended method in infants (two-thumb-encircling hand techniques) with two new methods (the new two-thumb and the knocking-fingers techniques) using a 15:2 compression-to-ventilation ratio. Ten qualified health professionals were recruited. Variables analysed were mean rate and the ratio of compressions in the recommended rate range, mean depth and the ratio of compressions within the depth range recommendations, ratio of compressions with adequate chest release and ratio of compressions performed with the fingers in the correct position. Ratios of correct compressions for depth, rate, chest release and hand position were always above 70% regardless of the technique used. Reached mean depth and mean rate were similar to the 3 techniques. No statistically significant differences were found in any of the variables analysed.

Conclusion: In an infant manikin, professionals are able to perform chest compressions with the new techniques with similar quality to that obtained with the standard method.

What is Known:

• Quality chest compressions are an essential prognostic factor in paediatric cardiorespiratory arrest.

• It has been reported poor results when studied cardiorespiratory resuscitation quality in infants applying the recommended methods.

What is New:

• In a simulated scenario, quality of chest compressions performed with two new techniques (nTTT and KF) is similar to that obtained with the currently recommended method (TTHT).


Advanced cardiac life support Cardiopulmonary resuscitation Heart massage Infant Paediatric emergency medicine 



Cardiopulmonary resuscitation


Interquartile ranges


Knocking-fingers technique


New two-thumb technique


Standard deviations


Two-finger technique


Two-thumb-encircling hand techniques


Author’s contributions

ER-R participated in the design of the study, reviewed the data and drafted the final manuscript. AM-P and AC-F carried out the fieldwork and the control of the quality of the data. CA-G participated in the design of the study and performed the statistical analysis and figures. AR-N participated in the design of the study, supervised the fieldwork and the elaboration of the results and reviewed the final manuscript.

Compliance with ethical statements

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Critical Care and Intensive Care Medicine Department,Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, University of Santiago de CompostelaSantiago de Compostela, A CoruñaSpain
  2. 2.CLINURSID research group of the University of Santiago de Compostela and Life Support and Simulation research group of the Health Research Institute of Santiago (FIDIS)Santiago de CompostelaSpain
  3. 3.School of NurseryUniversity of Santiago de CompostelaSantiago de Compostela, A CoruñaSpain
  4. 4.School of Education SciencesUniversity of Santiago de CompostelaSantiago de Compostela, A CoruñaSpain
  5. 5.Paediatric Intensive Care UnitUniversity Clinical Hospital of Santiago de Compostela, SERGAS, University of Santiago de CompostelaSantiago de Compostela, A CoruñaSpain
  6. 6.Maternal and Child Health and Development Research Network SAMID-III, Institute of Health Carlos IIIMadridSpain

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