What is the proper technique for chest compressions in the newborn?
The two acceptable techniques for performing chest compressions are applying two thumbs superimposed or next to each other on the sternum with the fingers surrounding the chest, or two fingers placed on the sternum at a right angle to the chest with the other hand supporting the back. Data suggest that the two-thumb method may have the advantage of generating peak systolic and coronary perfusion, and it is preferred by providers. Placement on the chest is at the lower third of the sternum. The rate should be approximately 90 times per minute at a 3:1 ratio with assisted ventilations. Take care not to simultaneously provide a breath while compressing the chest. Compress the chest to one third of the anteroposterior diameter of the chest. Compressions must be adequate to generate a pulse. Reassess the heart rate every 30 seconds during this time and continue compressions until there is a spontaneous heart rate over 60 beats per minute. Avoid interruptions of chest compressions.
Kattwinkel J, Perlman JM, Aziz K, et al: Part 15: Neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122(18 Suppl 3):S909-S919.