STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, MA 02115, USA.
Am J Emerg Med. 2011 Jul;29(6):618-25. doi: 10.1016/j.ajem.2010.01.008. Epub 2010 May 1.
High-quality chest compressions (CCs) are an important component of successful resuscitation. Suboptimal in-hospital CC are commonly reported. Skill degradation and fatigue have been implicated. We assessed the effect of a handheld feedback device on the measured and perceived quality of CC and rescuer physiologic response.
This is a nonblinded randomized controlled study of nurses at an academic medical center. Participants performed CC on a mannequin either with or without a feedback device. Compression rate (CR) and compression depth (CD), heart rate, and oxygen saturation were documented. Perceived quality of CC, fatigue, and ease of use of the device were obtained.
Twelve nurses were in the feedback group (FG) and 13 were controls. Mean CD was significantly higher in the FG (1.99 ± 0.37 in vs 1.52 ± 0.36 in; P = .005) and mean CR significantly lower in the FG (127 ± 13.8 per min vs 101 ± 9.7 per min; P ≤ .0001). Using a CD of more than 1.5 in and a CR of 90 to 100 as a composite measure of high-quality CC, the FG performed significantly better (81.4% ± 22.0% vs 10.4% ± 21.9%; P < .0001). Perceived CD, CR, and fatigue did not differ between groups; however, participants overestimated depth and underestimated rate. The FG rated the design as user-friendly (85% + 26%) helpful in maintaining correct CR (83% + 26%).
A handheld accelerometer-based audiovisual cardiopulmonary resuscitation (CPR) feedback device significantly improved the quality of CCs provided by experienced hospital nurses in a simulated setting, with no perceived or measured difference in fatigue between the 2 groups. The CPR feedback provides an effective means to monitor and improve CPR performance.
高质量的胸外按压（CC）是成功复苏的重要组成部分。医院内 CC 效果不佳的情况较为常见，这与技能下降和疲劳有关。我们评估了手持式反馈设备对 CC 质量和抢救者生理反应的测量和感知效果。
这是一项在学术医疗中心进行的针对护士的非盲随机对照研究。参与者在使用或不使用反馈设备的情况下对模型进行 CC。记录按压速率（CR）和按压深度（CD）、心率和血氧饱和度。获得 CC 的感知质量、疲劳和设备易用性的评价。
12 名护士在反馈组（FG），13 名护士在对照组。FG 的平均 CD 明显更高（1.99 ± 0.37 厘米与 1.52 ± 0.36 厘米；P =.005），FG 的平均 CR 明显更低（127 ± 13.8 次/分与 101 ± 9.7 次/分；P ≤.0001）。使用 1.5 厘米以上的 CD 和 90-100 次/分的 CR 作为高质量 CC 的综合测量标准，FG 的表现明显更好（81.4% ± 22.0%与 10.4% ± 21.9%；P <.0001）。两组间感知 CD、CR 和疲劳无差异；然而，参与者高估了深度，低估了速率。FG 对设计的评价为用户友好（85%+26%），有助于维持正确的 CR（83%+26%）。
在模拟环境中，使用基于手持式加速度计的心肺复苏（CPR）反馈设备可显著提高有经验的医院护士提供的 CC 质量，两组间疲劳感无差异。CPR 反馈提供了一种监测和改善 CPR 性能的有效方法。
