Single rescuer cardiopulmonary resuscitation: Can anyone perform to the guidelines 2000 recommendations?
Single rescuer cardiopulmonary resuscitation: Can anyone perform to the guidelines 2000 recommendations?
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DOI：
10.1016/j.resuscitation.2006.02.020
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发表时间：
2006-10-01
期刊：
影响因子：
6.5
通讯作者：
Ewy, Gordon A.
中科院分区：
文献类型：
--
作者：
Higdon, Travis A.;Heidenreich, Joseph W.;Ewy, Gordon A.
背景：2000年《心肺复苏和紧急心血管护理指南》建议，对于成人心脏骤停，单个救援者应执行“两次快速呼吸，然后进行15次胸外按压”。这一循环将继续下去，直到更多的救援人员到达。此前的研究表明，门外汉和医学生分别用16+/-1和14+/-1的S来进行这两次快呼吸。这项研究的目的是确定训练有素的专业辅助消防员进行这两次呼吸所需的时间，以及任何增加进行救援性呼吸所需时间对单一救援者BLS CPR期间胸部按压次数的影响。我们假设训练有素的专业救援者在模拟单个救援者BLS CPR时，在每15次按压前进行两次呼吸的时间也会比指南建议的要长得多。方法：根据AHA 2000 CPR指南，对24名目前获得BLS CPR认证的护理消防员进行了评估，以评估他们在4s内实现建议的两次呼吸的能力。另外，还传授了一种简化的持续胸部按压BLS CPR(CCC)技术，并与标准BLS CPR(STD)进行了比较。在没有透露研究目的的情况下，护理人员被要求对录制的Anne(R)白色心肺复苏进行单个救援者的BLSCPR。结果：在STD-CPR过程中提供两次快呼吸所需的平均时间为10+/-1 S。AHA BLS CPR的平均胸外按压次数仅为44+/-2。持续的胸外按压CPR导致每分钟88+/-5次按压(STD与CCC；P<；0.0001)。结论：训练有素的专业急救人员进行急救呼吸的速度略快于非专业救护人员或医科学生，但仍比建议的时间长2.5倍。进行这些呼吸所需的时间显著减少了每分钟进行的胸部按压次数。这可能会影响结果，因为实验研究表明，每分钟进行80次以上的按压对于长时间心脏骤停的生存是必要的。(C)2006爱思唯尔爱尔兰有限公司。保留所有权利。
Background: The Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care recommend that for adult cardiac arrest the single rescuer performs "two quick breaths followed by 15 chest compressions." This cycle is continued until additional help arrives. Previous studies have shown that lay persons and medical students take 16 +/- 1 and 14 +/- 1 s, respectively, to perform these "two quick breaths." The purpose of this study was to determine the time required for trained professional paramedic firefighters to deliver these two breaths and the effects that any increase in the time it takes to perform rescue breathing would have on the number of chest compressions delivered during single rescuer BLS CPR. We hypothesized that trained professional rescuers would also take substantially longer then the Guidelines recommendation for delivering the two rescue breaths before every 15 compressions during simulated single rescuer BLS CPR.Methods: Twenty-four paramedic firefighters currently certified to perform BLS CPR were evaluated for their ability to deliver the two recommended breaths within 4s according to the AHA 2000 CPR Guidelines. Alternatively, a simplified technique of continuous chest compression BLS CPR (CCC) was also taught and compared with standard BLS CPR (STD). Without revealing the purpose of the study the paramedics were asked to perform single rescuer BLS CPR on a recording Resusci Anne (R) white being videotaped.Results: The mean length of time needed to provide the "two quick breaths" during STD-CPR was 10 +/- 1 s. The mean number of chest compressions/min delivered with AHA BLS CPR was only 44 +/- 2. Continuous chest compression CPR resulted in 88 +/- 5 compressions delivered per minute (STD versus CCC; p < 0.0001).Conclusions: Trained professional emergency rescue workers perform rescue breathing somewhat faster than lay rescuers or medical students, but still require two and one half times longer than recommended. The time required to perform these breaths significantly decreases the number of chest compressions delivered per minute. This may affect outcome as experimental studies have shown that more than 80 compressions delivered per minute are necessary for survival from prolonged cardiac arrest. (c) 2006 Elsevier Ireland Ltd. All rights reserved.