Bystander Cardiopulmonary Resuscitation Quality: Potential for Improvements in Cardiac Arrest Resuscitation.
Bystander Cardiopulmonary Resuscitation Quality: Potential for Improvements in Cardiac Arrest Resuscitation.
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DOI：
10.1161/jaha.120.017930
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发表时间：
2021-03-16
影响因子：
5.4
通讯作者：
Rea T
中科院分区：
文献类型：
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作者：
Chocron R;Jobe J;Guan S;Kim M;Shigemura M;Fahrenbruch C;Rea T
旁观者心肺复苏（CPR）是提高院外心脏骤停后生存率的关键干预措施。我们评估了旁观者CPR的质量，以及是否根据旁观者的数量或提供电信CPR （TCPR）的情况而有所不同。我们调查了在6个月期间发生在大型大都市紧急医疗系统的非创伤性院外心脏骤停。通过回顾9‐1‐1记录、急诊医疗系统和医院记录来确定旁观者CPR状态（无CPR、TCPR和无辅助）、现场旁观者人数和CPR性能指标（压缩分数和压缩率），确定旁观者护理信息。在428例符合条件的院外心脏骤停患者中，76.4%接受了旁观者CPR，包括43.7%的无辅助CPR和56.3%的TCPR；35.2%有1名旁观者，33.3%有2名旁观者，31.5%有≥3名旁观者。总压缩率为59%，压缩率为每分钟88次。心肺复苏术根据TCPR状态（分数=52%，TCPR率=87 /分钟；分数=69%，无辅助CPR率=102，每个比较P<0.05）和旁观者数量（分数=55%，1名旁观者率=87 /分钟，分数=59%，2名旁观者率=89，分数=65%，≥3名旁观者率=97，每个指标的趋势检验P<0.05）而有所不同。其他旁观者行为不常见，包括旋转压缩机（3.1%）或应用自动体外除颤器（8.0%）。通过压缩分数和比率来衡量的旁观者CPR质量接近指导目标，尽管效果取决于CPR的类型和旁观者的数量。
Bystander cardiopulmonary resuscitation (CPR) is a critical intervention to improve survival following out‐of‐hospital cardiac arrest. We evaluated the quality of bystander CPR and whether performance varied according to the number of bystanders or provision of telecommunicator CPR (TCPR). We investigated non‐traumatic out‐of‐hospital cardiac arrest occurring in a large metropolitan emergency medical system during a 6‐month period. Information about bystander care was ascertained through review of the 9‐1‐1 recordings in addition to emergency medical system and hospital records to determine bystander CPR status (none versus TCPR versus unassisted), the number of bystanders on‐scene, and CPR performance metrics of compression fraction and compression rate. Of the 428 eligible out‐of‐hospital cardiac arrest, 76.4% received bystander CPR including 43.7% unassisted CPR and 56.3% TCPR; 35.2% had one bystander, 33.3% had 2 bystanders, and 31.5% had ≥3 bystanders. Overall compression fraction was 59% with a compression rate of 88 per minute. CPR differed according to TCPR status (fraction=52%, rate=87 per minute for TCPR versus fraction=69%, rate=102 for unassisted CPR, P<0.05 for each comparison) and the number of bystanders (fraction=55%, rate=87 per minute for 1 bystander, fraction=59%, rate=89 for 2 bystanders, fraction=65%, rate=97 for ≥3 bystanders, test for trend P<0.05 for each metric). Additional bystander actions were uncommon to include rotation of compressors (3.1%) or application of an automated external defibrillator (8.0%). Bystander CPR quality as gauged by compression fraction and rate approached guideline goals though performance depended upon the type of CPR and number of bystanders.