• Gun Hee Jung, Je Hyeok Oh, Chan Woong Kim, Sung Eun Kim, and Dong Hoon Lee.
• Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
• Eur J Emerg Med. 2017 Aug 1; 24 (4): 255-261.

ObjectiveWe evaluated the decrease in chest compression depth during 30 : 2 compression-to-ventilation ratio one-handed chest compression (OHCC) in an out-of-hospital pediatric arrest setting, and whether switching hands every other cycle could maintain compression depth.MethodsA 5-year-old child-sized manikin was used, and 50 medical students participated in the present study. First, the participants performed 5 min OHCC with a 30 : 2 compression-to-ventilation ratio on the floor (baseline test). Second, the compression technique was changed from the OHCC to the two-handed chest compression when they became subjectively fatigued (test 1). Third, the compression hand was alternated every other cycle (test 2). Average compression depth (ACD) data were recorded using an accelerometer device.ResultsACD changed significantly during the baseline test (0-1 min: 44.5±5.3 mm, 1-2 min: 43.7±6.1 mm, 2-3 min: 43.4±6.5 mm, 3-4 min: 43.2±6.5 mm, and 4-5 min: 42.3±6.5 mm, P=0.012). However, no significant differences were observed during test 1 or test 2. The baseline ACD value for the 4-5-min interval [95% confidence interval (CI), 40.5-44.2 mm] was significantly lower than those in test 1 (95% CI, 43.0-45.9 mm, P=0.004) and test 2 (95% CI, 42.4-45.9 mm, P=0.004). No differences in the ACDs at any interval were observed between test 1 and test 2.ConclusionCompression depth decreased significantly after 4 min during 30 : 2 ratio OHCC. However, it was maintained by changing from the OHCC to the two-handed chest compression or by alternating compression hands every other cycle.

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