NCJ Number
248077
Journal
Child Abuse and Neglect Volume: 38 Issue: 7 Dated: July 2014 Pages: 1267-1274
Date Published
July 2014
Length
8 pages
Annotation
This study investigated the incidence of posterior rib fractures related to the "two-thumbs" technique used for cardiopulmonary resuscitation of newborns and infants.
Abstract
This study on the incidence of posterior rib fractures related to the "two-thumbs" technique used for cardiopulmonary resuscitation (CPR) of newborns and infants found no evidence of rib fracture in the 50 infants who received CPR using the "two-thumbs" method immediately after birth. Data for the study were obtained from computerized databases used by three German children's hospitals. Cases involving infants within a 10-year period who were less than 12 months old and who underwent professional CPR were identified and all cases involving infants who received anterior-posterior chest radiographs taken after CPR were included in the study. Expert review of the radiographs identified 80 infants with 546 chest radiographs; 50 of those infants underwent CPR immediately after birth. The purpose of the study was to determine whether the posterior rib fractures found in the radiographs could be caused by the "two-thumbs" method of CPR. The "two-thumbs" method has been identified as being similar to the grip on an infant's thorax while shaking. The findings from the study suggest that this method of CPR used in infants and newborns is uncommon and that careful consideration of abuse should be warranted when these fractures are identified, regardless of whether CPR was performed and what technique was used. Study limitations are discussed. Tables, figures, and references