Institute of Molecular Medicine, Cardiovascular and Renal research, University of Southern Denmark, Denmark.
Am J Emerg Med. 2013 Feb;31(2):395-400. doi: 10.1016/j.ajem.2012.08.029. Epub 2012 Nov 14.
Our objective was to reduce hands-off time during cardiopulmonary resuscitation as increased hands-off time leads to higher mortality.
The European Resuscitation Council (ERC) 2005 and ERC 2010 guidelines were compared with an alternative sequence (ALT). Pulseless ventricular tachycardia and asystole were presented randomly to all participants in a simulation setting. A manikin (Resusci Anne; Laerdal Scandinavia A/S, Stavanger, Norway) and a defibrillator (LIFEPACK 12; Physio-Control, Inc, Redmond, WA, USA) were used. In ALT, chest compressions were only interrupted for postcharging rhythm analysis and immediate shock delivery. Comparing ALT to ERC 2005 and ERC 2010 shock delivery was done using paddles and pads, respectively.
Sample sizes were calculated with α of .05 and 90% power. Hence, we needed 4 and 12 participants, respectively. In ERC 2005 vs ALT, 10 physicians were included. All had prior experience in advanced life support. Chest compressions were shorter interrupted using ALT (mean, 6.7 vs 13.0 seconds). Analyzing data for ventricular tachycardia scenarios only, hands-off time was shorter using ALT (mean, 7.1 vs 18.2 seconds). In ERC 2010 vs ALT, 12 physicians were included. Two physicians had not prior experience in advanced life support. Hands-off time was reduced using ALT (mean, 3.9 vs 5.6 seconds). Looking solely at ventricular tachycardia scenarios, hands-off time was shortened using ALT (mean, 4.5 vs 7.6 seconds). No significant reduction was observed in either of the asystole scenarios.
In a simulation setting, we demonstrated that charging of the defibrillator before rhythm analysis significantly reduced hands-off time compared with the ERC 2005 and ERC 2010 guidelines.
我们的目标是减少心肺复苏过程中的脱手时间，因为脱手时间的增加会导致死亡率的升高。
将欧洲复苏委员会（ERC）2005 年和 ERC 2010 年指南与替代序列（ALT）进行比较。在模拟环境中向所有参与者随机呈现无脉性室性心动过速和心搏停止。使用复苏安妮模拟人（Laerdal Scandinavia A/S，斯塔万格，挪威）和 Lifepack 12 除颤器（Physio-Control，Inc.，雷德蒙德，华盛顿州，美国）。在 ALT 中，仅在充电后进行节律分析和立即电击时中断胸外按压。分别使用电极片和电极板比较 ALT 与 ERC 2005 年和 ERC 2010 年的电击输送。
使用 α 为.05 和 90%的功率计算样本量。因此，我们分别需要 4 名和 12 名参与者。在 ERC 2005 年与 ALT 相比，纳入 10 名医生。所有人均具有高级生命支持经验。使用 ALT 中断胸外按压时间更短（平均，6.7 秒与 13.0 秒）。仅分析室性心动过速场景的数据，使用 ALT 时脱手时间更短（平均，7.1 秒与 18.2 秒）。在 ERC 2010 年与 ALT 相比，纳入 12 名医生。其中 2 名医生没有高级生命支持经验。使用 ALT 减少了脱手时间（平均，3.9 秒与 5.6 秒）。仅在室性心动过速场景中，使用 ALT 缩短了脱手时间（平均，4.5 秒与 7.6 秒）。在两种心搏停止场景中均未观察到显著减少。
在模拟环境中，我们证明与 ERC 2005 年和 ERC 2010 年指南相比，在进行节律分析之前对除颤器充电可显著减少脱手时间。
