鈥?span style='font-style: italic'>Push as Hard as You Can鈥?Instruction for Telephone Cardiopulmonary Resuscitation: A Randomized Simulation Study

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• 作者：Raphael van Tulder ; MD^&lowast ; ; ^&dagger ; ; Dominik Roth ; MD^&lowast ; ; Christof Havel ; MD^&lowast ; ; Philip Eisenburger ; MD^&lowast ; ; Benedikt Heidinger ; MD^&lowast ; ; Christof Constantin Chwojka^&Dagger ; ; Heinz Novosad^&Dagger ; ; Fritz Sterz ; MD^&lowast ; ; Harald Herkner ; MD ; MSc^&lowast ; ; ; Wolfgang Schreiber ; MD^&lowast ;
• 关键词：cardiopulmonary resuscitation ; out-of-hospital cardiac arrest ; chest compression ; manikin ; telephone
• 刊名：Journal of Emergency Medicine
• 出版年：March, 2014
• 年：2014
• 卷：46
• 期：3
• 页码：363-370
• 全文大小：359 K

文摘

Background

The medical priority dispatch system (MPDS庐) assists lay rescuers in protocol-driven telephone-assisted cardiopulmonary resuscitation (CPR).

Objective

Our aim was to clarify which CPR instruction leads to sufficient compression depth.

Methods

This was an investigator-blinded, randomized, parallel group, simulation study to investigate 10聽min of chest compressions after the instruction 鈥減ush down firmly 5聽cm鈥?vs. 鈥減ush as hard as you can.鈥?Primary outcome was defined as compression depth. Secondary outcomes were participants exertion measured by Borg scale, provider's systolic and diastolic blood pressure, and quality values measured by the skill-reporting program of the Resusci^庐 Anne Simulator manikin. For the analysis of the primary outcome, we used a linear random intercept model to allow for the repeated measurements with the intervention as a covariate.

Results

Thirteen participants were allocated to control and intervention. One participant (intervention) dropped out after min 7 because of exhaustion. Primary outcome showed a mean compression depth of 44.1聽mm, with an inter-individual standard deviation (SD_b) of 13.0聽mm and an intra-individual standard deviation (SD_w) of 6.7聽mm for the control group vs. 46.1聽mm and a SD_b of 9.0聽mm and SD_w of 10.3聽mm for the intervention group (difference: 1.9; 95% confidence interval 鈭?.9 to 10.8; p = 0.66). Secondary outcomes showed no difference for exhaustion and CPR-quality values.

Conclusions

There is no difference in compression depth, quality of CPR, or physical strain on lay rescuers using the initial instruction 鈥減ush as hard as you can鈥?vs. the standard MPDS^庐 instruction 鈥減ush down firmly 5聽cm.鈥?/div>