Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Emerg Med J. 2013 Aug;30(8):628-32. doi: 10.1136/emermed-2012-201605. Epub 2012 Aug 27.
In real cardiopulmonary resuscitation (CPR), noise can arise from instructional voices and environmental sounds in places such as a battlefield and industrial and high-traffic areas. A feedback device using a flashing light was designed to overcome noise-induced stimulus saturation during CPR. This study was conducted to determine whether 'flashlight' guidance influences CPR performance in a simulated noisy setting.
We recruited 30 senior medical students with no previous experience of using flashlight-guided CPR to participate in this prospective, simulation-based, crossover study. The experiment was conducted in a simulated noisy situation using a cardiac arrest model without ventilation. Noise such as patrol car and fire engine sirens was artificially generated. The flashlight guidance device emitted light pulses at the rate of 100 flashes/min. Participants also received instructions to achieve the desired rate of 100 compressions/min. CPR performances were recorded with a Resusci Anne mannequin with a computer skill-reporting system.
There were significant differences between the control and flashlight groups in mean compression rate (MCR), MCR/min and visual analogue scale. However, there were no significant differences in correct compression depth, mean compression depth, correct hand position, and correctly released compression. The flashlight group constantly maintained the pace at the desired 100 compressions/min. Furthermore, the flashlight group had a tendency to keep the MCR constant, whereas the control group had a tendency to decrease it after 60 s.
Flashlight-guided CPR is particularly advantageous for maintaining a desired MCR during hands-only CPR in noisy environments, where metronome pacing might not be clearly heard.
在实际心肺复苏（CPR）中，噪音可能来自战场和工业及交通繁忙地区等地方的指导声音和环境声音。为了克服 CPR 过程中噪音引起的刺激饱和，设计了一种使用闪光灯的反馈装置。本研究旨在确定在模拟嘈杂环境中，“闪光灯”指导是否会影响 CPR 性能。
我们招募了 30 名没有使用闪光灯指导 CPR 经验的高年级医学生，参与这项前瞻性、基于模拟、交叉研究。实验在没有通气的心脏骤停模型中，在模拟嘈杂环境中进行。人工产生巡逻车和消防车警笛声等噪音。闪光灯指导装置以 100 次闪烁/分钟的速度发出光脉冲。参与者还收到了达到 100 次按压/分钟的目标率的指示。使用带有计算机技能报告系统的 Resusci Anne 模型记录 CPR 表现。
在平均压缩率（MCR）、MCR/分钟和视觉模拟量表方面，对照组和闪光灯组之间存在显著差异。然而，正确的压缩深度、平均压缩深度、正确的手位和正确释放的压缩之间没有显著差异。闪光灯组始终保持在期望的 100 次按压/分钟的节奏。此外，闪光灯组有保持 MCR 不变的趋势，而对照组在 60 秒后有降低 MCR 的趋势。
在嘈杂环境中进行仅手 CPR 时，闪光灯指导 CPR 特别有利于保持所需的 MCR，因为节拍器可能听不清楚。
