Yun Seong-Woo, Lee Byung Kook, Jeung Kyung Woon, Park Sang Wook, Choi Sung Soo, Lee Chang-Hee, Ryu So-Yeon
Department of Emergency Medical Technology, Namseoul University, 91 Daehak-ro, Sebuk-gu, Cheonan, Republic of Korea.
Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.
Am J Emerg Med. 2014 Aug;32(8):851-5. doi: 10.1016/j.ajem.2014.04.008. Epub 2014 Apr 15.
A step stool is an ordinary device to improve the quality of chest compression (CC) during in-hospital cardiopulmonary resuscitation (CPR). We investigated the effect of an inclined step stool on the quality of CC during CPR on a hospital bed.
We conducted a randomized crossover study of simulation using a manikin. Two different methods of CC were performed and compared: CC using a flat stool and CC using an inclined (20°) stool. Each session of CC was performed for 2 minutes using a metronome at a rate of 110 beats per minute. The primary outcome was the depth of CC. The adequate CC rate, duty cycle, rate of incomplete recoil, and the angle between the arm of the participants and the bed were also measured.
The median value of the mean depth of CC was 50.5 mm (45.0-57.0 mm) in the flat stool group and 54.5 mm (47.0-58.3 mm) in the inclined stool group (P = .014). The adequate CC rate was significantly higher in the inclined stool group (84.2% [37.6%-99.1%] vs 57.0% [15.2%-95.0%]; P = .016). The duty cycle and the rate of incomplete recoil were comparable between the 2 groups. The angles between the arm of the participants and the bed were more vertical in the inclined stool group (84.0° ± 5.2° vs 81.0° ± 4.8°; P = .014).
Using an inclined stool resulted in an improvement in the depth of CC and the adequate CC rate without increasing the rate of incomplete chest recoil.
阶梯凳是一种用于提高院内心肺复苏（CPR）期间胸外按压（CC）质量的普通装置。我们研究了倾斜阶梯凳对在医院病床进行CPR时CC质量的影响。
我们使用人体模型进行了一项随机交叉模拟研究。进行并比较了两种不同的CC方法：使用平板凳进行CC和使用倾斜（20°）凳进行CC。每次CC使用节拍器以每分钟110次的速率进行2分钟。主要结局是CC的深度。还测量了足够的CC率、按压与放松时间比、不完全回弹率以及参与者手臂与床之间的角度。
平板凳组CC平均深度的中位数为50.5毫米（45.0 - 57.0毫米），倾斜凳组为54.5毫米（47.0 - 58.3毫米）（P = 0.014）。倾斜凳组足够的CC率显著更高（84.2% [37.6% - 99.1%] 对57.0% [15.2% - 95.0%]；P = 0.016）。两组之间的按压与放松时间比和不完全回弹率相当。倾斜凳组参与者手臂与床之间的角度更垂直（84.0°±5.2°对81.0°±4.8°；P = 0.014）。
使用倾斜凳可提高CC深度和足够的CC率，且不会增加不完全胸壁回弹率。
