Critical Care Medicine Research Group, Department of Intensive Care Medicine, Tampere University Hospital and University of Tampere, PO Box 2000, FI-33521 Tampere, Finland; Emergency Medical Services, Department of Emergency Medicine, Turku University Hospital, PO Box 52, FI-20521 Turku, Finland.
Critical Care Medicine Research Group, Department of Intensive Care Medicine, Tampere University Hospital and University of Tampere, PO Box 2000, FI-33521 Tampere, Finland; School of Medicine, University of Tampere, FI-33014 University of Tampere, Finland.
Resuscitation. 2014 Jun;85(6):840-3. doi: 10.1016/j.resuscitation.2014.03.009. Epub 2014 Mar 19.
Implementation of chest compression (CC) feedback devices with a single force and deflection sensor (FDS) may improve the quality of CPR. However, CC depth may be overestimated if the patient is on a compliant surface. We have measured the true CC depth during in-hospital CPR using two FDSs on different bed and mattress types.
This prospective observational study was conducted at Tampere University Hospital between August 2011 and September 2012. During in-hospital CPR one FDS was placed between the rescuer's hand and the patient's chest, with the second attached to the backboard between the patient's back and the mattress. The real CC depth was calculated as the difference between the total depth from upper FDS to lower FDS.
Ten cardiac arrests on three different bed and mattress types yielded 10,868 CCs for data analyses. The mean (SD) mattress/bed frame effect was 12.8 (4) mm on a standard hospital bed with a gel mattress, 12.4 (4) mm on an emergency room stretcher with a thin gel mattress and 14.1 (3) mm on an ICU bed with an emptied air mattress. The proportion of CCs with an adequate depth (≥50 mm) decreased on all mattress types after compensating for the mattress/bed frame effect from 94 to 64%, 98 to 76% and 91 to 17%, in standard hospital bed, emergency room stretcher and ICU bed, respectively (p<0.001).
The use of FDS without real-time correction for deflection may result in CC depth not reaching the recommended depth of 50 mm.
使用单一力和挠度传感器(FDS)实施胸部按压(CC)反馈装置可能会提高 CPR 的质量。但是,如果患者处于顺应性表面上,则 CC 深度可能会被高估。我们使用两种不同床和床垫类型的 FDS 测量了住院期间 CPR 期间的真实 CC 深度。
这项前瞻性观察研究于 2011 年 8 月至 2012 年 9 月在坦佩雷大学医院进行。在住院期间 CPR 期间,将一个 FDS 置于施救者的手和患者的胸部之间,将第二个 FDS 置于患者背部和床垫之间的背板上。真实的 CC 深度是通过从上一个 FDS 到下一个 FDS 的总深度来计算的。
在三种不同的床和床垫类型上发生了 10 次心脏骤停,为数据分析提供了 10868 次 CC。在带有凝胶床垫的标准医院床上,床垫/床架的平均(SD)影响为 12.8(4)mm;在带有薄凝胶床垫的急诊室担架上,为 12.4(4)mm;在带有排空空气床垫的 ICU 床上,为 14.1(3)mm。补偿床垫/床架效应后,所有床垫类型上的 CC 深度均达到足够深度(≥50mm)的比例均降低,从标准医院床的 94%降至 64%,从急诊室担架的 98%降至 76%,从 ICU 床的 91%降至 17%(p<0.001)。
使用没有实时挠度校正的 FDS 可能会导致 CC 深度未达到推荐的 50mm 深度。