Sánchez Baltasar, Algarte Ramón, Piacentini Enrique, Trenado Josep, Romay Eduardo, Cerdà Manel, Ferrer Ricard, Quintana Salvador
Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain; Cardiorespiratory Arrest Committee, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
Intensive Care Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain.
J Crit Care. 2015 Aug;30(4):711-4. doi: 10.1016/j.jcrc.2015.03.001. Epub 2015 Mar 7.
We aimed to analyze compliance with 2010 European guidelines' quality criteria for external chest compressions (ECC) during 2 minutes of uninterrupted cardiopulmonary resuscitation.
Seventy-two healthy nurses and physicians trained in advanced cardiopulmonary resuscitation performed 2 uninterrupted minutes of ECC on a training manikin (Resusci Anne Advanced SkillTrainer; Laerdal Medical AS, Stavanger, Norway) that enabled us to measure the depth and rate of ECC. When professionals agreed to participate in the study, we recorded their age, body mass index (BMI), smoking habit, and their own subjective estimation of their physical fitness. To measure fatigue, we analyzed participants' heart rates, percentage of maximum tolerated heart rate (MHR), and subjective perception of their fatigue on a visual analog scale.
Nearly half (48.6%) the rescuers failed to achieve a minimum average ECC depth of 50 mm. Only 48.1% of ECCs fulfilled the 2010 guidelines' quality criteria; quality deteriorated mainly after the first minute. Poor ECC quality and deteriorating quality after the first minute were associated with BMI < 23 kg/m(2). Rescuers with BMI ≥ 23 kg/m(2) fulfilled the quality criteria throughout the 2 minutes, whereas those with BMI < 23 kg/m(2) fulfilled them for 80% of ECCs during the first minute, but for only 30% at the end of the 2 minutes.
Compliance with the 2010 guidelines' quality criteria is often poor, mainly due to lack of proper depth. The greater depth recommended in the 2010 guidelines with respect to previous guidelines requires greater force, so BMI < 23 kg/m(2) could hinder compliance. Limiting each rescuer's uninterrupted time doing ECC to 1 minute could help ensure compliance.
我们旨在分析在持续2分钟的不间断心肺复苏过程中，对2010年欧洲指南中胸外按压（ECC）质量标准的依从情况。
72名接受过高级心肺复苏培训的健康护士和医生在训练模拟人（复苏安妮高级技能训练器；挪威斯塔万格的Laerdal Medical AS公司）上进行了2分钟不间断的胸外按压，该模拟人能够测量胸外按压的深度和速率。当专业人员同意参与研究时，我们记录了他们的年龄、体重指数（BMI）、吸烟习惯以及他们对自身身体素质的主观评估。为了测量疲劳程度，我们分析了参与者的心率、最大耐受心率（MHR）百分比以及他们在视觉模拟量表上对疲劳的主观感受。
近一半（48.6%）的救援人员未能达到至少50毫米的平均胸外按压深度。只有48.1%的胸外按压符合2010年指南的质量标准；质量主要在第一分钟后恶化。胸外按压质量差以及第一分钟后质量恶化与BMI<23 kg/m²相关。BMI≥23 kg/m²的救援人员在整个2分钟内都符合质量标准，而BMI<23 kg/m²的救援人员在第一分钟内80%的胸外按压符合标准，但在2分钟结束时仅为30%。
对2010年指南质量标准的依从性通常较差，主要是由于缺乏适当的深度。2010年指南相对于先前指南推荐的更大深度需要更大的力量，因此BMI<23 kg/m²可能会妨碍依从性。将每个救援人员不间断进行胸外按压的时间限制在1分钟可能有助于确保依从性。
