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Donald M. Yealy

UPMC Media Relations

Two-Thumb Chest Compressions in Infant CPR Work Better Than The Two-Finger Method, Find University of Pittsburgh Researchers

PITTSBURGH, August 15, 2000 — For infants in cardiac arrest, the two-thumb infant cardiopulmonary resuscitation (CPR) method works better than the two-finger method, according to three studies conducted by researchers at the University of Pittsburgh. These findings are part of the new emergency cardiac care guidelines presented today by the American Heart Association (AHA).

The AHA currently recommends two-finger chest compressions for infants in cardiac arrest. However, based on the University of Pittsburgh studies, the AHA has included the two-thumb compression method as an acceptable and alternative means of infant CPR in its new guidelines.

"We believe the two-thumb technique is both an easier and more effective method of infant CPR. With further clinical trials, we will be able to prove this method is superior to the current two-finger method," says Jim Menegazzi, Ph.D., research associate professor of emergency medicine at the University of Pittsburgh School of Medicine and principal investigator of the studies.

The two-thumb method works by placing both thumbs on the lower third of the infant’s sternum with the fingers cradled around the infant’s back and chest. A total of five compressions are done alternating with one breath of mouth-to-mouth rescue breathing. This technique works better because it combines simultaneous sternal compression with lateral compression, or squeezing of the chest, unlike the two-finger method, which uses only the sternal compression.

The two-thumb method is also easier to perform because it causes less finger fatigue, according to the University of Pittsburgh studies.

The team’s studies concluded the two-thumb method produced significantly higher systolic blood pressure, higher coronary perfusion pressure and a higher sternal compression force than the two-finger method, thus efficiently increasing blood flow to the heart and the body.

"CPR has often been based on best guess or consensus views. Dr. Menegazzi’s simple observations into improving infant CPR represent a new potential benefit to these little patients. These studies also represent another University of Pittsburgh data-driven initiative to saving lives in those suffering sudden cardiac arrest," stated Donald M. Yealy, M.D., professor and vice chairman of the department of emergency medicine at the University of Pittsburgh School of Medicine.

The three major causes of infant cardiac arrest are respiratory arrest, sudden infant death syndrome and drowning.

The Pittsburgh Emergency Medicine Foundation provided funding for these studies.

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