The potential of leg-foot chest compression as an alternative to conventional hands-on compression during cardiopulmonary resuscitation
The potential of leg-foot chest compression as an alternative to conventional hands-on compression during cardiopulmonary resuscitation
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DOI：
10.1177/1024907918790068
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发表时间：
2019-03-01
影响因子：
0.6
通讯作者：
Yoshino, Atsuto
中科院分区：
文献类型：
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作者：
Takahashi, Yoshiaki;Saitoh, Takeji;Yoshino, Atsuto
背景资料：在心肺复苏术中，传统的手工胸外按压往往是不够的，特别是当救援人员虚弱或体格矮小时。目的：本研究旨在探讨心肺复苏过程中，在有或没有脚凳的情况下，腿-脚胸部按压的潜力。方法和结果：我们前瞻性地纳入了21名能够胜任基本生命支持的医务人员。他们在人体模型上进行心肺复苏2分钟，使用传统的手按压（HO），腿-脚按压（LF），腿-脚按压与脚凳（LF + FS）。我们分析了按压深度、救援人员生命体征的变化以及试验后的改良博格量表评分。使用HO和LF的病例之间的压缩深度没有差异。在LF + FS的情况下，观察到的压迫深度> 5 cm的频率（中位数，四分位数间距：93%，81%-100%）高于HO（9%，0%-57%，p < 0.01）和LF（28%，11%-47%，p < 0.01）。试验后，HO组和LF组的心率或改良博格量表评分的增加没有差异;而LF + FS的值最低（HO组49 +/- 18次/分和5（4-7）次，LF组46 +/- 18次和6（5-7）次，LF + FS组32 +/- 11次和2（1-3）次，p < 0.01）。然而，血压、SpO（2）和呼吸频率的增加在各组之间没有差异。心率和改良博格量表评分的增加与救援人员的体型呈负相关，在HO和LF的情况下，而不是LF + FS。结论：当难以充分HO时，LF可用作HO的替代方案。LF + FS可用于当救援人员虚弱或体型较小时，以及当受害者比救援人员大时。
Background: Conventional hands-on chest compression, in cardiopulmonary resuscitation, is often inadequate, especially when the rescuers are weak or have a small physique. Objectives: This study aimed to investigate the potential of leg-foot chest compression, with and without a footstool, during cardiopulmonary resuscitation. Methods and Results: We prospectively enrolled 21 medical workers competent in basic life support. They performed cardiopulmonary resuscitation on a manikin for 2 min using conventional hands-on compression (HO), leg-foot compression (LF), and leg-foot compression with a footstool (LF + FS). We analyzed the compression depths, changes in the rescuers' vital signs, and the modified Borg scale scores after the trials. The compression depth did not differ between the cases using HO and LF. In the case of LF + FS, compression depths > 5 cm were more frequently observed (median, inter-quartile range: 93%, 81%-100%) than in HO (9%, 0%-57%, p < 0.01) and LF (28%, 11%-47%, p < 0.01). The increase in the heart rate or modified Borg scale scores, after the trials, did not differ between the HO and LF group; however, the values were the lowest in the case of LF + FS (49 +/- 18 beats/min and 5 (4-7) in HO, 46 +/- 18 and 6 (5-7) in LF, and 32 +/- 11 and 2 (1-3) in LF + FS, respectively, p < 0.01). However, the increase in blood pressure, SpO(2), and respiratory rate were not different among each group. The increases in the heart rate and modified Borg scale scores negatively were correlated with the rescuers' body size, in the case of HO and LF, but not LF + FS. Conclusion: LF can be used as an alternative to HO, when adequate HO is difficult. LF + FS could be used when rescuers are weak or have a small physique and when the victims are bigger than the rescuers.