Oslo University Hospital HF, Institute for Experiemental Medical Research, PO Box 4956 Nydalen, N-0424 Oslo, Norway.
Resuscitation. 2012 Apr;83(4):494-9. doi: 10.1016/j.resuscitation.2011.09.021. Epub 2011 Oct 5.
We wanted to study the effect of continuous dispatcher communication on CPR technique and performance during 10min of simulated cardiac arrest.
We reviewed video recordings and manikin data from 30 CPR trained lay people who where left alone in a simulated cardiac arrest situation with a manikin in a home-like environment (in a small, confined kitchen with the disturbing noise of a radio). CPR was performed for 10min with continuous telephone instructions via speaker function from a dispatcher. The dispatcher was blinded for CPR performance and video. Dispatcher communication, compression technique and ventilation technique was scored as accomplished or failed in the 1st and 10th minute.
29/30 rescuers were able to hear instructions, answer questions from the dispatcher and perform CPR in parallel. Rescuer position beside manikin was initially correct for 13/30, improving to 21/30 (p=0.008). Compression technique was adequate for the whole episode, with an insignificant trend for improvement; 29 to 30/30 using straight arms, 28 to 30/30 in a vertical position over chest and 24 to 27/30 counting loudly. 17/29 placed their hands between the nipples initially, improving to 24/29 (p=0.065). Mean compression rate improved from 84 to 101min(-1) (p<0.001), and compression depth maintained adequate (43 to 42mm). Initially, 17/29 used chin-lift manoeuvre, 14/30 used head-tilt and 19/29 used nose pinch to manage open airways, compared to 18, 20 and 22/29 (ns) in the 10th minute, respectively. Successful delivery of ventilation improved from 13/30 to 23/30 (p=0.006).
Bystander and dispatcher can communicate successfully during ongoing CPR using a telephone with speaker function. CPR technique and quality improved or did not change over 10min with continuous dispatcher assistance. These results suggest a potential for improved bystander CPR using rescuer-dispatcher teamwork.
我们旨在研究在模拟心脏骤停的 10 分钟内，持续与调度员进行沟通对心肺复苏（CPR）技术和效果的影响。
我们回顾了 30 名接受过心肺复苏培训的非专业人员在家庭环境中的模拟心脏骤停情况下的视频记录和人体模型数据。（在一个小而封闭的厨房中，人体模型周围有收音机的干扰噪音）。在配备扬声器功能的电话的连续指导下，CPR 持续进行了 10 分钟。调度员对心肺复苏表现和视频进行了盲测。在第 1 分钟和第 10 分钟，调度员对沟通、按压技术和通气技术进行了成功或失败的评分。
30 名救援人员中，有 29 名能够听到指令、回答调度员的问题并同时进行心肺复苏。最初，有 13 名救援人员在人体模型旁边的位置正确，后来增加到 21 名（p=0.008）。在整个过程中，按压技术都是足够的，且有逐渐提高的趋势；29 名至 30 名救援人员使用直臂，28 名至 30 名救援人员垂直按压在胸部，24 名至 27 名救援人员大声计数。17 名救援人员最初将手放在乳头之间，后来增加到 24 名（p=0.065）。平均按压频率从 84 次/分钟提高到 101 次/分钟（p<0.001），且按压深度保持适当（43 至 42mm）。最初，17 名救援人员使用抬颏手法，14 名救援人员使用仰头法，19 名救援人员使用捏鼻法来保持气道通畅，而在第 10 分钟，分别有 18、20 和 22 名救援人员使用这些方法（无统计学差异）。成功通气的比例从 13 名救援人员增加到 23 名（p=0.006）。
在使用配备扬声器功能的电话进行的持续心肺复苏期间，旁观者和调度员可以成功进行沟通。在持续调度员协助下，CPR 技术和质量在 10 分钟内得到改善或没有改变。这些结果表明，通过救援人员-调度员团队合作，旁观者心肺复苏的效果可能会得到改善。
