University of California San Diego (UCSD), Rady's Children's Hospital, San Diego, CA 92123-4282, USA.
Resuscitation. 2010 Jun;81(6):718-23. doi: 10.1016/j.resuscitation.2010.01.029. Epub 2010 Mar 11.
Recent adult reports have demonstrated sub-optimal performance of basic cardiopulmonary resuscitation (CPR) skills in advanced training scenarios and real life arrest situations. We studied the adequacy of chest compressions performed by advanced trained pediatric providers in code scenarios.
We designed a prospective observational study of pediatric providers performing external closed-chest compressions on a child mannequin that is designed to assess adequacy based on depth and rate of chest compressions. The study was conducted from 2008 to 2009 in which 42 subjects were screened and enrolled for participation. Each subject underwent a basic life support scenario that included two minutes of uninterrupted external closed-chest compressions that were assessed for adequacy based on depth and rate.
For 42 subjects, 168 total 30-s time segments were available for analysis. Chest compressions were performed at a median rate of 110 (interquartile range (IQR) of 75-145) compressions per minute (cpm). No significant decay in rate of chest compressions was noted over the two-minute evaluation. Chest compression depth was adequate in 9.4% of total delivered chest compressions. No statistical significance was found on the job exposure to CPR and delivery of effective chest compressions.
Advanced training of pediatric providers does not ensure adequate delivery of chest compressions. Rate standards and adequate depth of chest compressions are infrequently achieved and both may need more emphasis in CPR training and attention during resuscitations.
最近的成人报告表明，在高级培训场景和现实生活中的急救情况下，基本心肺复苏（CPR）技能的表现并不理想。我们研究了在编码场景中经过高级培训的儿科提供者进行的胸部按压的充分性。
我们设计了一项前瞻性观察研究，研究对象为在儿童模型上进行外部闭合式胸部按压的儿科提供者，该模型旨在根据深度和按压频率来评估充分性。该研究于 2008 年至 2009 年进行，共筛选并招募了 42 名参与者。每位参与者都接受了一项基本生命支持场景的测试，包括两分钟不间断的外部闭合式胸部按压，根据深度和频率对其充分性进行评估。
对于 42 名受试者，共有 168 个总 30 秒时间段可用于分析。胸部按压的中位数频率为 110 次/分钟（四分位距（IQR）为 75-145 次/分钟）。在两分钟的评估过程中，没有发现按压频率明显下降。在总实施的胸部按压中，有 9.4%的按压深度是足够的。在 CPR 接触和有效胸部按压的实施方面，工作经验并没有显著差异。
对儿科提供者进行高级培训并不能确保充分实施胸部按压。频率标准和足够的胸部按压深度很少达到，这两者在 CPR 培训和复苏过程中可能需要更多的关注。
