Emerg Med J 30:139-142 doi:10.1136/emermed-2011-200978
  • Original articles

Comparison of overlapping (OP) and adjacent thumb positions (AP) for cardiac compressions using the encircling method in infants

  1. Won Joon Jeong4
  1. 1Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, South Korea
  2. 2Chonnam National University Hospital, Gwangju, South Korea
  3. 3Chungbuk National University, Cheongju, South Korea
  4. 4Konyang University, Daejeon, South Korea
  1. Correspondence to Dr YeonHo You, Department of Emergency Medicine, College of Medicine, Chungnam National University Hospital, 640 Daesa-dong, Jung-gu Metropolitan City, Daejon 301-721, South Korea; yyo1003{at}
  1. Contributors All authors have made substantive contributions to the study, and all authors endorse the data and conclusions.

  • Accepted 12 February 2012
  • Published Online First 8 March 2012


Objectives The aim of this manikin study was to compare the efficiency between overlapping (OP) and adjacent thumb positions (AP) for cardiac compressions using the encircling method in infants.

Methods The study conducted from December 2010 to August 2011 involved 48 volunteers who were students in the emergency medical technician course. The authors let volunteers practice OP and AP as a crossover design. The authors monitored the simulated mean arterial pressure (MAP) generated during a 5-min chest compression. The fatigue level of the volunteers after the chest compression was evaluated with the Likert scale.

Results There were no significant differences in MAP between the dominant hand and the non-dominant hand as the lower thumb of OP. Significant differences were observed in simulated systolic blood pressure, MAP and simulated pulse pressure between OP and AP at 1, 2, 3, 4 and 5 min. There were no significant differences among the changes in heart rate, respiratory rate and end-tidal CO2 during a 5-min chest compression by OP and AP. The Likert scale scores (1 no fatigue to 5= extreme fatigue) during the 5-min chest compressions were higher in AP than in OP at 2, 3 and 5 min.

Conclusion Higher intrathoracic pressures were achieved by OP in this study. However, further studies are needed to validate these effects of overlapping thumbs technique in infant cardiopulmonary resuscitation, not manikin.


  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Regional Ethics committee at Chungnam national university hospital Institution, South Korea.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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