Heidenreich Joseph W, Higdon Travis A, Kern Karl B, Sanders Arthur B, Berg Robert A, Niebler Rob, Hendrickson Jared, Ewy Gordon A
University of Arizona College of Medicine, University of Arizona Sarver Heart Center, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
Resuscitation. 2004 Sep;62(3):283-9. doi: 10.1016/j.resuscitation.2004.05.013.
The Guidelines 2000 for CPR and ECC recommend for single lay-rescuers performing basic life support, "two quick breaths followed by 15 chest compressions", repeated until professional help arrives. It is uncertain that this can actually be accomplished by the majority of lay rescuers. We evaluated 53 first-year medical students after completing BLS CPR training to determine if they could deliver the goal of 80 compressions per minute when following this AHA BLS recommendation. Alternatively, a simplified technique of uninterrupted chest compression (UCC) BLS CPR was also taught and compared with standard BLS CPR (STD). The mean number of chest compressions/minute delivered with AHA BLS CPR was only 43 +/- 1 immediately after initial training and 49 +/- 2 when tested 6 months later. Uninterrupted chest compression BLS resulted in 113 +/- 2 compressions/min delivered immediately after training and 91 +/- 4 six months later (STD versus UCC; P < 0.0001). The mean length of time needed to provide the two breaths during STD-CPR was 14 +/- 1 and 12 +/- 1s (immediately after first training and six months after training). For STD-CPR, the mean minute ventilation was poor immediately after initial training (3.3 +/- 0.3 l/min) and further declined (1.9 +/- 0.4 l/min) at 6 months (P = 0.003). For single rescuer basic cardiopulmonary resuscitation, motivated BLS CPR-trained medical students take nearly as long as previously reported for middle-aged lay individuals to deliver these "two quick breaths". The "Guidelines 2000" recommendation for "two quick breaths" is an oxymoron, as it averages more than 13s. New recommendations for single-rescuer CPR should be considered that emphasize uninterrupted chest compressions.
《2000年心肺复苏和心脏急救指南》建议，对于实施基本生命支持的非专业单人施救者，应“先进行两次快速呼吸，然后进行15次胸外按压”，重复操作直至专业救援人员到达。多数非专业施救者能否实际做到这一点尚不确定。我们对53名完成基础生命支持心肺复苏培训的一年级医学生进行了评估，以确定他们按照美国心脏协会基础生命支持的这一建议操作时，能否达到每分钟80次按压的目标。另外，还教授了一种简化的不间断胸外按压（UCC）基础生命支持心肺复苏技术，并与标准基础生命支持心肺复苏（STD）进行比较。接受美国心脏协会基础生命支持心肺复苏培训后，最初培训后即刻每分钟胸外按压的平均次数仅为43±1次，6个月后测试时为49±2次。不间断胸外按压基础生命支持在培训后即刻每分钟按压次数为113±2次，6个月后为91±4次（STD与UCC对比；P<0.0001）。在标准心肺复苏过程中，进行两次呼吸所需的平均时间在首次培训后即刻为14±1秒，培训6个月后为12±1秒。对于标准心肺复苏，最初培训后即刻平均每分钟通气量较差（3.3±0.3升/分钟），6个月时进一步下降（1.9±0.4升/分钟）（P = 0.003）。对于单人施救者基本心肺复苏，经过积极培训的基础生命支持心肺复苏医学生进行这“两次快速呼吸”所用的时间几乎与之前报道的中年非专业人员一样长。《2000年指南》中“两次快速呼吸”的建议自相矛盾，因为平均用时超过13秒。应考虑针对单人施救者心肺复苏提出新的建议，强调不间断胸外按压。
