Effect of mattress deflection on CPR quality assessment for older children and adolescents
Effect of mattress deflection on CPR quality assessment for older children and adolescents
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DOI：
10.1016/j.resuscitation.2009.02.006
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发表时间：
2009-05-01
期刊：
影响因子：
6.5
通讯作者：
Nadkarni, Vinay
中科院分区：
文献类型：
--
作者：
Nishisaki, Akira;Nysaether, Jon;Nadkarni, Vinay
适当的胸外按压 (CC) 深度与心肺复苏效果的改善相关。医院提供的 CC 通常在兼容的床垫上进行。目的是量化床垫压缩对儿童心肺复苏质量评估的影响。方法：在儿童医院儿科重症监护室和急诊科进行心肺复苏期间使用力和偏转传感器 (FDS)。传感器插在患者胸部和救援人员双手之间，测量 CC 深度。在心肺复苏事件之后，每个事件都使用人体模型和相同的床垫/背板/患者配置进行重建。使用胸骨上的 FDS 和连接在人体模型脊柱上的参考加速度计进行 CC，提供了一种计算床垫偏转的方法。结果：记录并重建了 12 例 14,487 CC 的心肺复苏事件（11 名患者，中位年龄 14.9 岁）：9 例在 ICU 床上（9296 CC），3 例在担架上（5191 CC）。心肺复苏期间测量的平均 CC 深度在 ICU 床上为 47 +/- 8 毫米，在担架床上为 45 +/- 7 毫米，由于床垫压缩，分别高估了 13 +/- 4 毫米和 4 +/- 1 毫米。对此进行调整后，ICU病床上符合CPR指南的CC比例从88.4%下降到31.8% (p < 0.001)，担架上的CC比例从86.3%下降到64.7% (p < 0.001 ICU病床上适当深度CC的比例明显较小(p < 0.001)。结论：在非刚性表面上进行的CC可能不够深。FDS可能高估ICU 病床上的 CC 深度增加了 28%，担架床上的 CC 深度增加了 10% (C) 2009 Elsevier Ireland Ltd。保留所有权利。
Appropriate chest compression (CC) depth is associated with improved CPR outcome. CCs provided in hospital are often conducted on a compliant mattress. The objective was to quantify the effect of mattress compression on the assessment of CPR quality in children.Methods: A force and deflection sensor (FDS) was used during CPR in the Pediatric Intensive Care Unit and Emergency Department of a children's hospital. The sensor was interposed between the chest of the patient and hands of the rescuer and measured CC depth. Following CPR event, each event was reconstructed with a manikin and an identical mattress/backboard/patient configuration. CCs were performed using FDS on the sternum and a reference accelerometer attached to the spine of the manikin, providing a means to Calculate the mattress deflection.Results: Twelve CPR events with 14,487 CC (11 patients, median age 14.9 years) were recorded and reconstructed: 9 on ICU beds (9296 CC), 3 on stretchers (5191 CC). Measured mean CC depth during CPR was 47 +/- 8 mm on ICU beds, and 45 +/- 7 mm on stretcher beds with overestimation of 13 +/- 4 mm and 4 +/- 1 mm, respectively, due to mattress compression. After adjusting for this, the proportion of CC that met the CPR guidelines decreased from 88.4 to 31.8% on ICU beds (p < 0.001), and 86.3 to 64.7% on stretcher (p < 0.001 The proportion of appropriate depth CC was significantly smaller on ICU beds (p < 0.001).Conclusion: CC conducted on a non-rigid surface may not be deep enough. FDS may overestimate CC depth by 28% on ICU beds, and 10% on stretcher beds. (C) 2009 Elsevier Ireland Ltd. All rights reserved.