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对于在模拟人上进行心肺复苏术表现欠佳的施救者而言,用优势手进行按压可提高胸外按压质量。

Compressing with dominant hand improves quality of manual chest compressions for rescuers who performed suboptimal CPR in manikins.

作者信息

Wang Juan, Tang Ce, Zhang Lei, Gong Yushun, Yin Changlin, Li Yongqin

机构信息

Emergency Department, Southwest Hospital, Third Military Medical University, Chongqing 400038, China; Medical Training Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.

School of Biomedical Engineering, Third Military Medical University, Chongqing 400038, China.

出版信息

Am J Emerg Med. 2015 Jul;33(7):931-6. doi: 10.1016/j.ajem.2015.04.007. Epub 2015 Apr 10.

DOI:10.1016/j.ajem.2015.04.007
PMID:25937378
Abstract

OBJECTIVE

The question of whether the placement of the dominant hand against the sternum could improve the quality of manual chest compressions remains controversial. In the present study, we evaluated the influence of dominant vs nondominant hand positioning on the quality of conventional cardiopulmonary resuscitation (CPR) during prolonged basic life support (BLS) by rescuers who performed optimal and suboptimal compressions.

METHODS

Six months after completing a standard BLS training course, 101 medical students were instructed to perform adult single-rescuer BLS for 8 minutes on a manikin with a randomized hand position. Twenty-four hours later, the students placed the opposite hand in contact with the sternum while performing CPR. Those with an average compression depth of less than 50 mm were considered suboptimal.

RESULTS

Participants who had performed suboptimal compressions were significantly shorter (170.2 ± 6.8 vs 174.0 ± 5.6 cm, P = .008) and lighter (58.9 ± 7.6 vs 66.9 ± 9.6 kg, P < .001) than those who performed optimal compressions. No significant differences in CPR quality were observed between dominant and nondominant hand placements for these who had an average compression depth of greater than 50 mm. However, both the compression depth (49.7 ± 4.2 vs 46.5 ± 4.1 mm, P = .003) and proportion of chest compressions with an appropriate depth (47.6% ± 27.8% vs 28.0% ± 23.4%, P = .006) were remarkably higher when compressing the chest with the dominant hand against the sternum for those who performed suboptimal CPR.

CONCLUSIONS

Chest compression quality significantly improved when the dominant hand was placed against the sternum for those who performed suboptimal compressions during conventional CPR.

摘要

目的

将优势手置于胸骨上是否能提高胸外按压质量这一问题仍存在争议。在本研究中,我们评估了优势手与非优势手放置位置对长时间基础生命支持(BLS)期间传统心肺复苏(CPR)质量的影响,这些复苏操作由进行最佳和次优按压的救援人员实施。

方法

在完成标准BLS培训课程6个月后,101名医学生被要求在模拟人上以随机的手部位置进行8分钟的成人单救援者BLS操作。24小时后,学生们在进行CPR时将对侧手置于胸骨上。平均按压深度小于50毫米的被视为次优。

结果

进行次优按压的参与者明显比进行最佳按压的参与者更矮(170.2±6.8厘米对174.0±5.6厘米,P = 0.008)且更轻(58.9±7.6千克对66.9±9.6千克,P < 0.001)。对于平均按压深度大于50毫米的人,优势手与非优势手放置位置在CPR质量上未观察到显著差异。然而,对于进行次优CPR的人,用优势手按压胸骨时,按压深度(49.7±4.2毫米对46.5±4.1毫米,P = 0.003)和具有适当深度的胸外按压比例(47.6%±27.8%对28.0%±23.4%,P = 0.006)均显著更高。

结论

对于在传统CPR期间进行次优按压的人,将优势手置于胸骨上时胸外按压质量显著提高。

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