One-handed versus two-handed chest compressions in paediatric cardio-pulmonary resuscitation

SummaryObjectivesTo determine emergency department (ED) staff preference for one- or two-handed paediatric chest compressions and to determine if there was a difference in compression rates delivered and fatigability between the techniques.MethodsThis was a randomised, cross-over observational study of paediatric CPR performed on a standard paediatric manikin by ED staff. Consenting, eligible staff [ED doctors and nurses] performed CPR in pairs with chest compressions delivered using a one- and two-handed technique. The outcomes of interest were compression rates for one- and two-handed CPR, decrease in compression rate over time for each technique and staff preference for technique. Data was analysed using descriptive statistics, Chi Square test and Mann–Whitney U-test as appropriate.ResultsSixty-two ED staff participated in the study. Compression rates with both techniques were similar and higher than guidelines recommend (133.6 min−1 for one-handed and 135.7 min−1 for two-handed respectively). The compression rate slowed by 6.9 compressions/min over 1 min in one-handed compressions compared with 2.6 compressions/min in two-handed compressions (p = 0.0264). 65.6% of participants reported that they preferred the two-handed compression technique.ConclusionThis study showed that CPR compression rate is similar with one- and two-handed compression techniques, but compression rate decreased more quickly with the one-handed technique. The majority of staff preferred the two-handed compression technique for reasons of ease, control and uniformity with other CPR techniques.