Proposal for Requirements of Effective Chest Compression in Cardiopulmonary Resuscitation

本研究的目的是综合评估心肺复苏（CPR）过程中照顾者的负担和胸外按压质量的变化，以确定有效胸外按压的要求。该研究包括实验1（2010年进行）和实验2（2011年）。实验1旨在阐明床高之间的关系，自由调整的照顾者，和人体测量值。它还通过采用各种床高和姿势主观评估其性能，检查了进行胸外按压的最有效和负担最小的姿势和高度。结果表明，当按压部位设置在股骨中心的高度时，护理人员进行胸外按压时感觉最舒适。当看护者进行胸外按压时，自由调整床高或膝盖放在床上时，胸外按压的准确性显着较高。实验2以临床实施的CPR为对象，研究了采用不同床高和姿势进行胸外按压时的身体负担与准确性之间的关系。因此，当他们在地板上进行心肺复苏术的基本要求，自由调整床的高度，或与他们的膝盖在床上时，胸外按压的准确性更高。另一方面，与在地板上的表现相比，当他们在床上进行膝盖时，他们的身体负担明显更大。基于这些结果，以下2种方法可以被认为是有效胸外按压的要求：1）将床上的按压部位设置为护理者股骨中心的高度; 2）将膝盖放在患者胸部旁边，脚趾接触地板。

The purpose of this study was to comprehensively evaluate caregivers' burden and changes in the quality of chest compressions performed by them during cardiopulmonary resuscitation(CPR) in order to determine the requirements for effective chest compressions. The study consisted of experiments 1(conducted in 2010) and 2(2011). Experiment 1 aimed to clarify the relationship between the bed height, freely adjusted by caregivers, and anthropometric values. It also examined the most effective and least burdensome posture and height to perform chest compressions by subjectively evaluating their performance adopting various bed heights and postures. As a result, it was shown that the caregivers felt most comfortable to perform chest compressions when the compression site was set to the height of the center of their femora. The accuracy of chest compressions was significantly high when the caregivers performed them, freely adjusting the bed height, or with their knees on the bed. Experiment 2 examined the relationship between the physical burden when performing chest compressions, adopting various bed heights and postures, and their accuracy, focusing on clinically performed CPR. As a result, the accuracy of chest compressions was higher when they were performed on the floor as a basic CPR requirement, freely adjusting the bed height, or with their knees on the bed. On the other hand, their physical burden was significantly greater when they were performed with their knees on the bed, compared to performance on the floor. Based on these results, the following 2 approaches may be considered as the requirements for effective chest compressions : 1) Setting the compression site on the bed to the height of the center of the caregiver's femur ; and 2) performing them with the knees placed beside the patient's chest and toes touching the floor.