Oh Jaehoon, Chee Youngjoon, Lim Taeho, Cho Youngsuk, Kim In Young
Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Korea.
Emerg Med Australas. 2014 Dec;26(6):585-90. doi: 10.1111/1742-6723.12307. Epub 2014 Oct 12.
We suggest an alternative chest compression (CC) in kneeling posture using a 'kneeling stool' on which the performer kneels beside the patient on a bed in-hospital. In kneeling posture, we can maintain high quality cardiopulmonary resuscitation (CPR) without the bed height adjustment, which is necessary and inconvenient in standing posture.
This study is a randomised crossover trial with 38 participants working in one ED. The first group knelt on the kneeling stool beside a manikin placed on a bed, whereas the second group stood on a step stool with the manikin at knee level using bed height adjustment. All the participants performed continuous chest compression for 5 min without audio-visual feedback. After that, the posture was changed in each group. The parameters of CC quality (CC depth, rate, accuracy, and incomplete chest recoil), visual analogue scale (VAS) for fatigue and pain, and preference of participants were compared between the two groups.
The data of 33 participants in both postures were analysed following exclusion of five participants. In the comparisons overall and per minute between the two postures, the parameters and VAS do not differ significantly (all P > 0.05) except for the median 1st CC rate that was faster in kneeling posture than in standing posture, P = 0.01). Twenty-three performers preferred the kneeling posture.
A kneeling posture with a kneeling stool were preferred by participants, which have shown similar results in CC parameters and VAS with a standing posture on a stepstool with bed height adjustment during in-hospital CPR.
我们建议采用一种替代的跪姿胸外按压（CC）方法，使用“跪凳”，施救者在医院病床边跪在患者身旁。采用跪姿时，我们无需调整床的高度就能维持高质量的心肺复苏（CPR），而在站姿时这一调整是必要且不便的。
本研究是一项随机交叉试验，有38名在一个急诊科工作的参与者。第一组跪在床边放置的人体模型旁的跪凳上，而第二组站在一个高脚凳上，通过调整床的高度使人体模型处于膝盖高度。所有参与者在没有视听反馈的情况下连续进行5分钟的胸外按压。之后，每组更换姿势。比较两组之间胸外按压质量参数（按压深度、频率、准确性和胸壁回弹不完全情况）、疲劳和疼痛的视觉模拟量表（VAS）以及参与者的偏好。
排除5名参与者后，分析了两种姿势下33名参与者的数据。在两种姿势的总体和每分钟比较中，除了跪姿的第1分钟胸外按压频率中位数比站姿快（P = 0.01）外，参数和VAS没有显著差异（所有P > 0.05）。23名施救者更喜欢跪姿。
参与者更喜欢使用跪凳的跪姿，在医院心肺复苏期间，跪姿在胸外按压参数和VAS方面与使用调整床高度的高脚凳的站姿显示出相似的结果。
