Could One-Hand Chest Compression for a Small Child Cause Intra-Abdominal Injuries?

We examined whether children ( < 18 years old) had risk of intra-thoracic trauma during 'one-handed' chest compressions through MDCT images. We measured the length of the lower half of the sternum (Stotal/2~X). We also measured the distance from the diaphragm to the midpoint of the sternum (Stotal/2~D) and half the width of an adult hand (Wtotal/2). All the 1 year-old children had Stotal/2~X and Stotal/2~D less than Wtotal/2. Among the children aged 2 years, 6 (60.0%) had Stotal/2~X and Stotal/2~D less than Wtotal/2. Among those aged 3 years, 4 (26.7%) had Stotal/2~X and Stotal/2~D less than Wtotal/2, and among those aged 4 years, 2 (13.3%) had Stotal/2~X and Stotal/2~D less than Wtotal/2. However, Stotal/2~X and Stotal/2~D were greater than Wtotal/2 in children aged 5 years or more. We knew that small children may be at an increased risk of intra-thoracic trauma during 'one-handed' chest compressions.