智能手机APP指导模式与调度员指导模式对目击者实施心肺复苏的作用及比较研究

A comparative study of dispatcher-assisted resuscitation and smart phone APPs for conducting cardiopulmonary resuscitation

目的研究应用智能手机APP或调度员电话指导目击者进行现场心肺复苏（cardiopulmonary resuscitation，CPR）的效用。方法将74名未经心肺复苏培训的志愿者随机分为非指导组（n=13）、调度员指导（dispatcher—assisted telephone—cardiopulmonary resuscitation，T—CPR）组（n=34）和APP指导组（n=27）；在模拟心搏骤停场景中，借助QCPR模拟人，记录3组志愿者实施5min单纯按压的心肺复苏过程中按压中断时间、按压位置、频率、深度和胸廓回弹的指标，并作比较。其中非指导组不接受任何心肺复苏指导；调度员指导组通过语音接受心肺复苏指导：APP指导组通过预先安装在安卓智能手机中的APP，以文字、语音和动画的方式向志愿者提供心肺复苏指导。采用SPSS19．0对各组指标行秩和检验。结果在按压中断时间（1．0s vs ．1．5s vs．5．0s）、按压平均速率（121．07次/min vs．127．5次／min vs．58．0次／min）、正确按压频率占比（99．0％vs．98．0％vs．0．0％）和按压平均深度（33．0cm vs．26．5cm vs．16．0cm）方面，APP指导组和调度员指导组表现相当，组间差异无统计学意义（P〉0．05），且均优于非指导组，差异有统计学意义（P〈0．05）。结论在提高目击者胸外按压质量方面，智能手机APP能起到和调度员电话指导相同的作用，从而提升目击者实施心肺复苏的效果。

Objective The purpose of our study was to assess the onset effect of bystander CPR assisted by a smart phone APP or by a dispatcher. Methods 74 volunteers, without any experience in basic life support measures, was randomly divided into three groups： no-assisted group （n=13）, dispatcher-assisted group （n=34） and smart phone APP-assisted group （n=27）. Under the condition of a simulative SCA, a QCPR mannequin was used to record the hands-off time, hand placement, rate, depth and complete chest recoil after each compression of the three different groups to make analysis. The no-assisted group didn＇t receive any CPR instruction; the dispatcher-assisted group was instructed to do CPR through the voice from the telephone; the smartpbone APP-assisted group was instructed by a preset Android smart phone CPR APP which guided the volunteers to do CPR step by step by words, voice and animations. Rank sum test analysis of each group using SPSS19.0 software. Results In aspects of hands-off time （1.0 second vs. 1.5 seconds vs. 5.0 seconds）, mean rate of compression （121.0 per minute vs. 127.5 per minute vs. 58.0 per minute）, percentage of correct compression rate （99.0% vs. 98.0% vs. 0.0%） and mean depth of compression （33.0 cm vs. 26.5 cm vs. 16.0 em）, smart phone APP-assisted group performed as well as dispatcher-assisted group （P〉0.05） and was superior to no-assisted group （P〈0.05）. Conclusion In terms of increasing the quality of CPR, the smart phone APP can play the same role as dispatcher＇s telephone guidance, so as to enhance the effect of cardiopulmonary resuscitation.