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Pediatric CPR without an advanced airway in place requires 15 compressions to 2 ventilations per AHA and ILCOR guidelines. This can lead to a 2-4 second pause in compressions due to the time the ventilations take. The Maryland hiccup method is a novel description of two brief pauses for ventilations during the upstroke of compressions 14 and 15. This method was shown to improve the compression fraction and compressions per minute with no significant differences between standard CPR and the Maryland hiccup method in ventilation volume or compression depth determined on simulation mannequins. 38 Maryland EMS clinicians participated in this study.
A video demonstration of the Maryland Hiccup method is linked in the article and also available at: https://www.youtube.com/watch?v=RvFxhj7hzsQ .
References
Anders JF, Anderson C, Wright-Johnson C, O'Connell KJ. Improving the Quality of Pediatric Basic Life Support Cardiopulmonary Resuscitation With a Novel Method: The Maryland Hiccup. Cureus. 2025 Feb 9;17(2):e78783. doi: 10.7759/cureus.78783. PMID: 39931503; PMCID: PMC11808343.