Jiang Cheng, Jiang Shan, Zhao Yan, Xu Bing, Zhou Xian-long
Medical College of Wuhan University, Wuchang, Wuhan, China; Emergency Center, Zhongnan Hospital of Wuhan University, Wuchang, Wuhan, China.
Medical College of Wuhan University, Wuchang, Wuhan, China.
J Emerg Med. 2015 Apr;48(4):436-44. doi: 10.1016/j.jemermed.2014.12.034. Epub 2015 Jan 31.
The 2010 cardiopulmonary resuscitation (CPR) guidelines increased the importance of external chest compression. However, the best hand position to be the compressing one has not been identified.
To investigate the effects of dominant or nondominant external chest compression hand position during CPR.
Medical students performed five cycles of conventional CPR and completed one questionnaire. The CPR performances were manually evaluated, and detailed aspects of the external chest compression quality were assessed via the SimMan® Essential system (Laerdal China Ltd., Hangzhou, China).
One hundred fifty-seven students participated in the nondominant hand (NH) group, and 68 students participated in the dominant hand (DH) group. The manual evaluations revealed no differences between the two groups. The proportion of chest compressions "above 100 cpm [compressions per minute]" was higher in the DH group than in the NH group (97% vs. 92%, respectively, p = 0.002). The frequency distributions of the chest compression rates were also significantly different between the two groups (p < 0.0001). The distribution of the NH group was concentrated within "130-139" cpm, whereas this distribution was concentrated within "140-149" cpm in the DH group. The chest compression depth of the DH group was deeper than that of the NH group (p = 0.001). The depth of the fifth cycle was significantly decreased compared with those of cycles 1, 2, and 3 in the NH group. A greater number of full chest recoils were observed in the NH group (p = 0.02).
The dominant hand position during CPR was associated with a higher chest compression rate, a greater chest compression depth, and delayed fatigue.
2010年心肺复苏（CPR）指南提高了胸外按压的重要性。然而，尚未确定最佳的按压手位。
探讨心肺复苏期间优势手或非优势手胸外按压手位的效果。
医学生进行五个周期的传统心肺复苏并完成一份问卷。通过人工评估心肺复苏表现，并通过SimMan® Essential系统（中国杭州挪度医疗器械有限公司）评估胸外按压质量的详细方面。
157名学生参与非优势手（NH）组，68名学生参与优势手（DH）组。人工评估显示两组之间无差异。DH组“每分钟按压次数超过100次”的胸外按压比例高于NH组（分别为97%和92%，p = 0.002）。两组之间胸外按压频率的分布也有显著差异（p < 0.0001）。NH组的分布集中在“130 - 139”次/分钟，而DH组的分布集中在“140 - 149”次/分钟。DH组的胸外按压深度比NH组更深（p = 0.001）。NH组中第五个周期的深度与第1、2和3个周期相比显著降低。在NH组中观察到更多的完全胸廓回弹（p = 0.02）。
心肺复苏期间优势手位与更高的胸外按压频率、更大的胸外按压深度和延迟疲劳有关。
