Effectiveness of finger-marker for maintaining the correct compression point during paediatric resuscitation: A simulation study

Am J Emerg Med. 2017 Sep;35(9):1303-1308. doi: 10.1016/j.ajem.2017.04.003. Epub 2017 Apr 11.

Abstract

Objective: High-quality cardiopulmonary resuscitation is a significant factor for increasing the survival rate of paediatric patients. This study is to investigate the effectiveness of finger-marker stickers for maintaining the correct compression point during simulated infant cardiopulmonary resuscitation (CPR).

Methods: This crossover simulation study was conducted with 40 emergency physicians and paramedics at emergency departments of 2 tertiary hospitals. We used a remodeled infant CPR manikin developed to measure CPR quality indicators. After random coupling of participants (20 pairs), the pre-group (10 pairs) performed conventional 2-rescuer infant manikin CPR, then performed sticker-applied CPR after 1month. The post-group (10 pairs) performed the process in the opposite order. The participants placed finger-marker stickers to indicate the appropriate compression point before starting CPR. We compared accurate finger placement rates and other CPR quality indicators (compression depth, rate, complete chest recoil, and hands-off time) with and without the finger-marker sticker.

Results: All finger-marker stickers were correctly attached within 5s (4.88±1.28s) of approaching the model. There were significant differences in the rate of correct finger compression position between conventional and sticker-applied CPR (25.4% [IQRs 7.6-69.8] vs. 88.2% [IQRs 69.6-95.5], P<0.001). Results did not differ according to sex, career, and job of the participants. There were no significant differences in mean compression rate, depth, hands-off times, and rate of fully recoiled compression between the 2 groups.

Conclusion: Finger-marker stickers can be used to maintain correct finger positioning during 2-rescuer infant manikin CPR.

Keywords: Cardiac arrest; Children; Heart massage; Infant; Resuscitation.

MeSH terms

  • Adult
  • Allied Health Personnel
  • Cardiopulmonary Resuscitation / education*
  • Cross-Over Studies
  • Female
  • Fingers*
  • Heart Arrest / therapy
  • Heart Massage / methods*
  • Humans
  • Infant
  • Male
  • Manikins
  • Physicians
  • Pressure
  • Prospective Studies
  • Quality Indicators, Health Care
  • Simulation Training*