Ashton A, McCluskey A, Gwinnutt C L, Keenan A M
Department of Anaesthesia, Stepping Hill Hospital, Stockport SK2 7JE, UK.
Resuscitation. 2002 Nov;55(2):151-5. doi: 10.1016/s0300-9572(02)00168-5.
Guidelines for the performance of cardiopulmonary resuscitation (CPR) have been revised recently and now advocate that chest compressions are performed without interruption for 3 min in patients during asystole and pulseless electrical activity. The aim of the present study was to determine if rescuer fatigue occurs during 3 min of chest compressions and if so, the effects on the rate and quality of compressions. Forty subjects competent in basic life support (BLS) were studied. They performed continuous chest compressions on a Laerdal Skillmeter Resusci-Anne manikin for two consecutive periods of 3 min separated by 30 s. The total number of compressions attempted was well maintained at approximately 100 min(-1) throughout the period of study. However, the number of satisfactory chest compressions performed decreased progressively during resuscitation (P < 0.001) as follows: first min, 82 min(-1); second, 68 min(-1); third, 52 min(-1); fourth, 70 min(-1); fifth, 44 min(-1); sixth, 27 min(-1). We observed significant correlations between the number of satisfactory compressions performed and both height and weight of the rescuer. Female subjects achieved significantly fewer satisfactory compressions compared with males (P = 0.03). Seven subjects (five female, two male) were unable to complete the second 3-min period because of exhaustion. We conclude that rescuer fatigue adversely affects the quality of chest compressions when performed without interruption over a 3-min period and that this effect may be greater in females due to their smaller stature. Consideration should be given to rotating the rescuer performing chest compressions after 1 min intervals.
心肺复苏（CPR）的操作指南最近已修订，现在提倡在心脏停搏和无脉电活动患者中进行不间断的胸部按压3分钟。本研究的目的是确定在3分钟的胸部按压过程中救援人员是否会出现疲劳，如果出现疲劳，对按压的速率和质量有何影响。对40名具备基本生命支持（BLS）能力的受试者进行了研究。他们在Laerdal Skillmeter复苏安妮人体模型上连续进行两个3分钟的胸部按压，中间间隔30秒。在整个研究期间，尝试的按压总数保持在约100次/分钟左右。然而，在复苏过程中，满意的胸部按压次数逐渐减少（P<0.001），如下所示：第一分钟，82次/分钟；第二分钟，68次/分钟；第三分钟，52次/分钟；第四分钟，70次/分钟；第五分钟，44次/分钟；第六分钟，27次/分钟。我们观察到满意按压次数与救援人员的身高和体重之间存在显著相关性。女性受试者获得的满意按压次数明显少于男性（P=0.03）。7名受试者（5名女性，2名男性）因疲劳无法完成第二个3分钟时段。我们得出结论，在3分钟内不间断进行胸部按压时，救援人员的疲劳会对按压质量产生不利影响，而且由于女性身材较小，这种影响可能更大。应考虑每隔1分钟轮换进行胸部按压的救援人员。
