Performance of chest compressions by laypersons during the Public Access Defibrillation Trial
Performance of chest compressions by laypersons during the Public Access Defibrillation Trial
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DOI：
10.1016/j.resuscitation.2009.12.002
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发表时间：
2010-03-01
期刊：
影响因子：
6.5
通讯作者：
Lank, Paula
中科院分区：
文献类型：
--
作者：
Rea, Thomas D.;Stickney, Ronald E.;Lank, Paula
背景资料：越来越多的证据表明，卫生专业人员往往可能无法达到心肺复苏术（CPR）的指导标准。鲜为人知的是外行CPR performance.Methods：这项调查是一项回顾性队列研究的心脏骤停患者治疗外行CPR和一个模型的自动体外除颤器（AED）的一部分，公众访问除颤试验（n = 26）。使用整合事件日志、ECG信号和胸阻抗信号的软件测量CPR。我们评估了胸部按压分数（比例的尝试复苏花费执行胸部按压），快速压缩分数（比例的尝试复苏花费执行压缩在AED提示期间），压缩命运，和压缩每分钟。结果：26例中，13例室颤和13 nonshockable心律。总体而言，在患者无自主循环期间，中位胸外按压分数为34%（IQR 17-48%），中位提示胸外按压分数为49%（IQR 30-66%），中位胸外按压速率为96/min（IQR 90-110/min）。总的来说，所有逮捕中每分钟的胸部按压中位数为29（IQR 20-42）。CPR特征根据初始节律不同而不同：心室颤动患者每分钟胸部按压的中位数为20次（IQR 13-29），不可电击节律患者为42次（IQR 28-47）（p = 0.003）。结论：在这项针对训练有素的外行的研究中，CPR变化很大，通常没有达到指南参数。研究结果表明，需要改善心肺复苏术培训，考虑改变心肺复苏术协议，和/或改善AED救援人员界面。(C)2009年由Elsevier爱尔兰有限公司出版。
Background: Increasing evidence indicates that health professionals often may riot achieve guideline standards for cardiopulmonary resuscitation (CPR). Little is known about layperson CPR performance.Methods: The investigation was a retrospective cohort study of cardiac arrest patients treated by layperson CPR and one model of automated external defibrillator (AED) as part of the Public Access Defibrillation Trial (n = 26). CPR was measured using software that integrates the event log, ECG signal, and thoracic impedance signal. We assessed chest compression fraction (proportion of attempted resuscitation spent performing chest compressions), Prompted compression fraction (proportion of attempted resuscitation spent performing compressions during AED-prompted periods), compression Fate, and compressions per minute.Results: Of the 26 cases, 13 presented with ventricular fibrillation and 13 with nonshockable rhythms. Overall, during the period when patients did not have spontaneous circulation, the median chest compression fraction was 34% (IQR 17-48%), median prompted chest compression fraction was 49% (IQR 30-66%), and the median chest compression rate was 96/min (IQR 90-110/min). Taken together, the median chest compression delivered per minute among all arrests was 29 (IQR 20-42). CPR characteristics differed according to initial rhythm: median chest compression per minute was 20 (IQR 13-29) among ventricular fibrillation and 42 (IQR 28-47) among nonshockable rhythms (p = 0.003).Conclusions: In this Study of trained laypersons, CPR varied Substantially and often did not achieve guideline parameters. The findings suggest a need to improve CPR training, consider changes to CPR protocols, and/or improve the AED-rescuer interface. (C) 2009 Published by Elsevier Ireland Ltd.