Higdon Travis A, Heidenreich Joseph W, Kern Karl B, Sanders Arthur B, Berg Robert A, Hilwig Ron W, Clark Lani L, Ewy Gordon A
University of Arizona College of Medicine, Sarver Heart Center, Tucson, AZ 85724, USA.
Resuscitation. 2006 Oct;71(1):34-9. doi: 10.1016/j.resuscitation.2006.02.020. Epub 2006 Aug 30.
The Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care recommend that for adult cardiac arrest the single rescuer performs "two quick breaths followed by 15 chest compressions." This cycle is continued until additional help arrives. Previous studies have shown that lay persons and medical students take 16 +/- 1 and 14 +/- 1 s, respectively, to perform these "two quick breaths." The purpose of this study was to determine the time required for trained professional paramedic firefighters to deliver these two breaths and the effects that any increase in the time it takes to perform rescue breathing would have on the number of chest compressions delivered during single rescuer BLS CPR. We hypothesized that trained professional rescuers would also take substantially longer then the Guidelines recommendation for delivering the two rescue breaths before every 15 compressions during simulated single rescuer BLS CPR.
Twenty-four paramedic firefighters currently certified to perform BLS CPR were evaluated for their ability to deliver the two recommended breaths within 4 s according to the AHA 2000 CPR Guidelines. Alternatively, a simplified technique of continuous chest compression BLS CPR (CCC) was also taught and compared with standard BLS CPR (STD). Without revealing the purpose of the study the paramedics were asked to perform single rescuer BLS CPR on a recording Resusci Anne while being videotaped.
The mean length of time needed to provide the "two quick breaths" during STD-CPR was 10 +/- 1 s. The mean number of chest compressions/min delivered with AHA BLS CPR was only 44 +/- 2. Continuous chest compression CPR resulted in 88 +/- 5 compressions delivered per minute (STD versus CCC; p < 0.0001).
Trained professional emergency rescue workers perform rescue breathing somewhat faster than lay rescuers or medical students, but still require two and one half times longer than recommended. The time required to perform these breaths significantly decreases the number of chest compressions delivered per minute. This may affect outcome as experimental studies have shown that more than 80 compressions delivered per minute are necessary for survival from prolonged cardiac arrest.
《2000年心肺复苏与心血管急救指南》建议，对于成人心脏骤停，单人施救者应进行“两次快速呼吸，随后进行15次胸外按压”。这一循环持续进行，直到有更多救援人员赶到。此前的研究表明，普通人和医学生分别需要16±1秒和14±1秒来完成这“两次快速呼吸”。本研究的目的是确定训练有素的专业护理人员消防员进行这两次呼吸所需的时间，以及进行呼吸所需时间的任何增加对单人基础生命支持心肺复苏期间胸外按压次数的影响。我们假设，在模拟单人基础生命支持心肺复苏过程中，训练有素的专业救援人员在每15次按压前进行两次救援呼吸所需的时间也会比指南建议的时间长得多。
对24名目前已获得基础生命支持心肺复苏认证的护理人员消防员进行评估，看他们是否有能力按照美国心脏协会2000年心肺复苏指南在4秒内完成两次推荐呼吸。另外，还教授了一种简化的持续胸外按压基础生命支持心肺复苏（CCC）技术，并与标准基础生命支持心肺复苏（STD）进行比较。在不透露研究目的的情况下，要求护理人员在录像时对模拟人Resusci Anne进行单人基础生命支持心肺复苏。
在标准心肺复苏期间提供“两次快速呼吸”所需的平均时间为10±1秒。采用美国心脏协会基础生命支持心肺复苏时每分钟胸外按压的平均次数仅为44±2次。持续胸外按压心肺复苏每分钟可进行88±5次按压（标准心肺复苏与持续胸外按压心肺复苏比较；p<0.0001）。
训练有素的专业急救人员进行呼吸的速度比普通救援人员或医学生稍快，但仍比建议时间长两倍半。进行这些呼吸所需的时间显著减少了每分钟胸外按压的次数。这可能会影响复苏结果，因为实验研究表明，要从长时间心脏骤停中存活下来，每分钟需要进行80多次按压。
