行驶车厢内对心脏骤停模拟人进行不同姿势胸外按压的分析研究

Comparasion on the quality of chest compressions with different postures for cardiac arrest model in the moving carriage

目的分析公交车的运动状态和在车厢内进行胸外按压的姿势对心肺复苏的成功率的影响。方法选取本院专业急救医护人员在公交车厢内对模拟人进行单纯胸外按压,将公交车的运动状态分为静止状态和行驶状态,胸外按压的姿势分别采用传统侧位跪式和骑跨跪式。采用Link CPR考核培训系统记录不同条件下胸外按压的平均深度、按压太深次数、按压太浅次数、按压平均频率、按压太快次数、按压太慢次数、胸外按压比例、按压达标次数、正确次数、正确率,记录按压后医护人员的疲劳量表(FS-14)。结果不同行驶状态下的车辆不同的按压姿势对胸外按压平均深度、按压太深次数、按压太浅次数、按压达标次数、FS-14有明显的影响(F分别=4.85、9.60、9.27、4.73、20.63,P均<0.05)。进一步两两比较,采用侧跪式进行胸外按压时,行驶状态下按压太浅次数明显多于静止状态,FS-14明显高于静止状态,差异均有统计学意义(t分别=3.07、6.06,P均<0.05)。车辆处于静止状态下,采用侧跪式胸外按压时胸外按压平均深度、按压太深次数、按压太浅次数、按压达标次数、FS-14明显优于骑跨式胸外按压,差异有统计学意义(t分别=6.67、5.71、-9.65、7.99、-8.61,P均<0.05)。当车辆处于行驶状态下,采用侧跪式进行胸外按压时胸外按压平均深度、按压太浅次数、按压达标次数、FS-14明显优于骑跨式胸外按压(t分别=3.56、-5.34、4.92、-2.18,P均<0.05)。结论公交车厢内行驶状态下的胸外按压是一种特殊状态的心肺复苏,需要适宜的行驶速度、公交车厢内的稳定环境、采用正确的传统侧位跪式胸外按压,这些因素都将有利于在行驶车厢内实施高质量的胸外按压,从而提高心肺复苏的成功率。

Objective To analyze the influence of the posture and carriage’s motion state on the efficiency of chest compressions.Methods Emergency personnel of Jinhua People's Hospital were selected to perform chest compressions in the bus carriage.The motion state of the bus carriage is divided into static state and moving state.And the posture included the traditional side-kneeling posture and the straddle posture.In different conditions,the Link CPR assessment training system was used to record the average depth of chest compressions,too deep compression times,too shallow compression times,average compression frequency,too fast compression times,too slow compression times,CCF,the standard compression times,the correct compression times and the accuracy.Then participants were required to complete the FS-14 and the data were recorded.Results The motion of the bus carriage and the posture of compression had obvious effects on average depth of chest compressions,too deep compressions times,too shallow compressions times,the standard compressions times and the FS-14 score(F=4.85,9.60,9.27,4.73,20.63,P<0.05).By pairwise comparisons,with the traditional side-kneeling posture,the times of too shallow compressions in the moving state was significantly more than that in the static state,and the FS-14 score in the moving state was significantly higher than that in the static state(t=3.07,6.06,P<0.05).In the static state,compared with the straddle posture,the side-kneeling posture had significant effects on the average depth of chest compressions,too deep compressions times,too shallow compressions times standard compressions times and FS-14 score(t=6.67,5.71,-9.65,7.99,-8.61,P<0.05).In the moving state,compared with the straddle posture,the side-kneeling posture had significant effects on the average depth of chest compressions,too shallow compressions times,standard compressions times and FS-14 score(t=3.56,-5.34,4.92,-2.18,P<0.05).Conclusion Chest compression in the moving carriage is a special form of cardiopulmonary resuscitation.Suitable speed,stable environment and traditional correct side-kneeling posture will contribute to the implementation of high-quality chest compressions in the carriage,so as to improve the efficiency of CPR.