A vertical two‐thumb technique is superior to the two‐thumb encircling technique for infant cardiopulmonary resuscitation

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.