Foo Ning-Ping, Chang Jer-Hao, Su Shih-Bin, Chen Kow-Tong, Cheng Ching-Fa, Chen Pei-Chung, Lin Tsung-Yi, Guo How-Ran
Department of Emergency Medicine, China Medical University-An Nan Hospital, Taichung, Taiwan; Department of Environmental and Occupational Health College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Emergency Medicine, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chia-Yi, Taiwan.
Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
PLoS One. 2014 Oct 15;9(10):e107960. doi: 10.1371/journal.pone.0107960. eCollection 2014.
The survival rate of patients with out-of-hospital cardiac arrest is low, and measures to improve the quality of cardiopulmonary resuscitation (CPR) during ambulance transportation are desirable. We designed a stabilization device, and in a randomized crossover trial we found performing CPR in a moving ambulance with the device (MD) could achieve better efficiency than that without the device (MND), but the efficiency was lower than that in a non-moving ambulance (NM).
To evaluate whether a modified version of the stabilization device, can promote further the quality of CPR during ambulance transportation.
Participants of the previous study were recruited, and they performed CPR for 10 minutes in a moving ambulance with the modified version of the stabilization device (MVSD). The primary outcomes were effective chest compressions and no-flow fraction recorded by a skill-reporter manikin. The secondary outcomes included back pain, physiological parameters, and the participants' rating about the device after performing CPR.
The overall effective compressions in 10 minutes were 86.4±17.5% for NM, 60.9±14.6% for MND, 69.7±22.4% for MD, and 86.6%±13.2% for MVSD (p<0.001). Whereas changes in back pain severity and physiology parameters were similar under all conditions, MVSD had the lowest no-flow fraction. Differences in effective compressions and the no-flow fraction between MVSD and NM did not reach statistical significance.
The use of the modified device can improve quality of CPR in a moving ambulance to a level similar to that in a non-moving condition without increasing the severity of back pain.
院外心脏骤停患者的生存率较低，因此需要采取措施提高救护车转运期间心肺复苏（CPR）的质量。我们设计了一种稳定装置，在一项随机交叉试验中，我们发现使用该装置（MD）在移动的救护车中进行心肺复苏比不使用该装置（MND）能达到更高的效率，但效率低于在非移动救护车（NM）中的效率。
评估改良版稳定装置是否能进一步提高救护车转运期间心肺复苏的质量。
招募了先前研究的参与者，他们在配备改良版稳定装置（MVSD）的移动救护车中进行了10分钟的心肺复苏。主要结局指标是由技能报告人体模型记录的有效胸外按压和无血流时间占比。次要结局指标包括背痛、生理参数以及参与者在进行心肺复苏后对该装置的评分。
10分钟内总体有效按压率分别为：NM为86.4±17.5%，MND为60.9±14.6%，MD为69.7±22.4%，MVSD为86.6%±13.2%（p<0.001）。尽管在所有情况下背痛严重程度和生理参数的变化相似，但MVSD的无血流时间占比最低。MVSD与NM之间在有效按压和无血流时间占比方面的差异未达到统计学意义。
使用改良装置可将移动救护车中心肺复苏的质量提高到与非移动状态相似的水平，且不会增加背痛的严重程度。
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