Department of Anaesthesia and Intensive Care Medicine, Stavanger University Hospital, Stavanger, Norway.
Crit Care Med. 2011 Feb;39(2):300-4. doi: 10.1097/CCM.0b013e3181ffe100.
The aim of this study was to evaluate whether socioemotional stress affects the quality of cardiopulmonary resuscitation during advanced life support in a simulated manikin model.
A randomized crossover trial with advanced life support performed in two different conditions, with and without exposure to socioemotional stress.
The study was conducted at the Stavanger Acute Medicine Foundation for Education and Research simulation center, Stavanger, Norway.
Paramedic teams, each consisting of two paramedics and one assistant, employed at Stavanger University Hospital, Stavanger, Norway.
A total of 19 paramedic teams performed advanced life support twice in a randomized fashion, one control condition without socioemotional stress and one experimental condition with exposure to socioemotional stress. The socioemotional stress consisted of an upset friend of the simulated patient who was a physician, spoke a foreign language, was unfamiliar with current Norwegian resuscitation guidelines, supplied irrelevant clinical information, and repeatedly made doubts about the paramedics' resuscitation efforts. Aural distractions were supplied by television and cell telephone.
The primary outcome was the quality of cardiopulmonary resuscitation: chest compression depth, chest compression rate, time without chest compressions (no-flow ratio), and ventilation rate after endotracheal intubation. As a secondary outcome, the socioemotional stress impact was evaluated through the paramedics' subjective workload, frustration, and feeling of realism. There were no significant differences in chest compression depth (39 vs. 38 mm, p = .214), compression rate (113 vs. 116 min⁻¹, p = .065), no-flow ratio (0.15 vs. 0.15, p = .618), or ventilation rate (8.2 vs. 7.7 min⁻¹, p = .120) between the two conditions. There was a significant increase in the subjective workload, frustration, and feeling of realism when the paramedics were exposed to socioemotional stress.
In this advanced life support manikin study, the presence of socioemotional stress increased the subjective workload, frustration, and feeling of realism, without affecting the quality of cardiopulmonary resuscitation.
本研究旨在评估社会心理应激是否会影响高级生命支持期间心肺复苏的质量，研究对象为模拟人体模型。
一项随机交叉试验，在高级生命支持期间进行了两种不同的条件，分别为有和无社会心理应激暴露。
挪威斯塔万格急性医学基金会教育与研究模拟中心。
挪威斯塔万格大学医院的 19 个急救小组，每个小组由两名急救人员和一名助理组成。
19 个急救小组以随机方式两次进行高级生命支持，一种为对照组，无社会心理应激；另一种为实验组，有社会心理应激。社会心理应激由模拟患者的心烦意乱的朋友引起，他是一名医生，讲外语，不熟悉当前挪威的复苏指南，提供不相关的临床信息，并反复对急救人员的复苏努力表示怀疑。听觉干扰由电视和手机提供。
主要结果是心肺复苏的质量：胸部按压深度、按压频率、无按压时间（无血流比）和气管内插管后的通气频率。作为次要结果，通过急救人员的主观工作量、挫折感和真实感来评估社会心理应激的影响。两种情况下的胸部按压深度（39 毫米对 38 毫米，p =.214）、按压频率（113 次/分钟对 116 次/分钟，p =.065）、无血流比（0.15 对 0.15，p =.618）或通气频率（8.2 次/分钟对 7.7 次/分钟，p =.120）均无显著差异。当急救人员暴露于社会心理应激时，主观工作量、挫折感和真实感显著增加。
在这项高级生命支持模拟人体研究中，社会心理应激的存在增加了主观工作量、挫折感和真实感，但没有影响心肺复苏的质量。
