Burkhardt Joshua N, Glick Joshua E, Terndrup Thomas E
Penn State College of Medicine, Hershey, Pennsylvania.
Ohio State University, Department of Emergency Medicine, Columbus, Ohio.
West J Emerg Med. 2014 Jul;15(4):404-8. doi: 10.5811/westjem.2014.1.19636.
The purpose of this study was to determine cardiopulmonary resuscitation (CPR) knowledge of hospital providers and whether knowledge affects performance of effective compressions during a simulated cardiac arrest.
This cross-sectional study evaluated the CPR knowledge and performance of medical students and ED personnel with current CPR certification. We collected data regarding compression rate, hand placement, depth, and recoil via a questionnaire to determine knowledge, and then we assessed performance using 60 seconds of compressions on a simulation mannequin.
Data from 200 enrollments were analyzed by evaluators blinded to subject knowledge. Regarding knowledge, 94% of participants correctly identified parameters for rate, 58% for hand placement, 74% for depth, and 94% for recoil. Participants identifying an effective rate of ≥100 performed compressions at a significantly higher rate than participants identifying <100 (μ=117 vs. 94, p<0.001). Participants identifying correct hand placement performed significantly more compressions adherent to guidelines than those identifying incorrect placement (μ=86% vs. 72%, p<0.01). No significant differences were found in depth or recoil performance based on knowledge of guidelines.
Knowledge of guidelines was variable; however, CPR knowledge significantly impacted certain aspects of performance, namely rate and hand placement, whereas depth and recoil were not affected. Depth of compressions was poor regardless of prior knowledge, and knowledge did not correlate with recoil performance. Overall performance was suboptimal and additional training may be needed to ensure consistent, effective performance and therefore better outcomes after cardiopulmonary arrest.
本研究的目的是确定医院工作人员的心肺复苏(CPR)知识,以及该知识是否会影响模拟心脏骤停期间有效按压的执行情况。
这项横断面研究评估了持有当前CPR认证的医学生和急诊科人员的CPR知识及操作表现。我们通过问卷调查收集了有关按压速率、手部位置、深度和回弹的数据以确定知识掌握情况,然后使用模拟人体模型进行60秒的按压来评估操作表现。
由对受试者知识情况不知情的评估人员对200名参与者的数据进行了分析。在知识方面,94%的参与者正确识别了速率参数,58%正确识别了手部位置,74%正确识别了深度,94%正确识别了回弹。识别出有效速率≥100的参与者进行按压的速率显著高于识别出<100的参与者(均值=117对94,p<0.001)。识别出手部位置正确的参与者遵循指南进行的按压显著多于识别出手部位置错误的参与者(均值=86%对72%,p<0.01)。基于对指南的了解,在深度或回弹操作表现方面未发现显著差异。
对指南的了解存在差异;然而,CPR知识显著影响了操作表现的某些方面,即速率和手部位置,而深度和回弹则未受影响。无论先前知识如何,按压深度都很差,且知识与回弹操作表现无关。总体操作表现欠佳,可能需要额外培训以确保持续、有效的操作,从而在心肺骤停后获得更好的结果。