A new chest compression depth indicator would increase compression depth without increasing overcompression risk - 05/12/15
, Joong Eui Rhee, MD, PhD 2, Kyuseok Kim, MD, PhD 1, Taeyun Kim, MD, PhD 1, You Hwan Jo, MD, PhD 1, Jae Hyuk Lee, MD, PhD 1, Yu Jin Kim, MD, PhD 1, Jae Yun Jung, MD, PhD 1Abstract |
Purpose |
Adequate chest compression (CC) depth is critical for effective cardiopulmonary resuscitation. Pediatric resuscitation guidelines recommend that CC be at least one-third of the anterior-posterior (AP) chest diameter or approximately 4 cm in infants and 5 cm in children. We aimed to find a better indicator of CC depth that maximizes CC depth while also minimizing injury.
Basic procedures |
Chest computed tomographic images of patients aged 8 years and younger were measured for external diameter (ED) (AP distance from skin to skin) and internal diameter (AP distance between internal surface of anterior chest wall and anterior surface of vertebral body) at the midway of the lower half of the sternum. Compressible depth was defined as 1 cm short of internal diameter. We determined that up to a 10% estimated risk of overcompression is acceptable and approximated a quantile regression line for the 10th percentile of compressible depth on ED. After rounding coefficients, we used its equation as a new indicator.
Main findings |
A total of 426 images were analyzed. The new indicator had a slope of 0.5 and an intercept of −1.9 cm (1 fingerbreadth). Compared to one-third ED, the new indicator would provide deeper CC with average difference of 1.9 mm (95% confidence interval, 1.6-2.2 mm) without increasing the risk of overcompression (both 4.9%). Chest compression of 4/5 cm would provide deeper CC compared to the new indicator (difference, 3.5 mm; 95% confidence interval, 2.7-4.1 mm); however, its overcompression risk was too high (31.5%).
Principal conclusion |
Chest compression of one-half ED minus 1 fingerbreadth maximizes CC depth without increasing overcompression in pediatric population.
Le texte complet de cet article est disponible en PDF.Plan
| ☆ | Prior presentations: None. |
| ☆☆ | Funding sources: None. |
| ★ | Conflicts of interest: All authors do not have any conflicts of interest. |
Vol 33 - N° 12
P. 1755-1759 - décembre 2015 Retour au numéro
Article précédent
- Femur fractures should not be considered distracting injuries for cervical spine assessment
- Robert T. Dahlquist, Peter E. Fischer, Harsh Desai, Amelia Rogers, A. Britton Christmas, Michael A. Gibbs, Ronald F. Sing
- Association of educational level with delay of prehospital care before reperfusion in STEMI
- Ju Yeon Heo, Ki Jeong Hong, Sang Do Shin, Kyoung Jun Song, Young Sun Ro
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?