听诊、触诊和叩诊：是时候重新评估了。

Auscultate, palpate and tap: time to re-evaluate.

作者信息

Hawkes G A, Hawkes C P, Kenosi M, Demeulemeester J, Livingstone V, Ryan C A, Dempsey E M

机构信息

Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.

Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland.

出版信息

Acta Paediatr. 2016 Feb;105(2):178-82. doi: 10.1111/apa.13169. Epub 2015 Oct 23.

DOI:10.1111/apa.13169

PMID:26317177

Abstract

AIM

To determine the accuracy of current methods of heart rate (HR) assessment.

METHODS

All participants palpated a simulated pulsating umbilicus (UMB), listened to a tapping rate (TAP) and auscultated a simulated HR (AUSC). A simulated HR of 54, 88 and 128 beats per minute (bpm) was randomised for all methods.

RESULTS

Twenty-nine healthcare staff participated in this study. Correct assessment of HR of 54 bpm as being within the 0-59 range occurred in 17.2% UMB, 17.2% TAP and 31% AUSC and was obtained in <10 seconds by 48.3%, 65.5% and 62.1%, respectively. A rate of 88 bpm was correctly assessed as within the 60-100 range in 82.8% UMB, 79.3% TAP and 79.3% AUSC and was obtained in <10 seconds by 55.2%, 58.6% and 55.2%, respectively. A rate of 128 bpm was identified as >100 bpm by 96.6% UMB, 93.1% TAP, and 93.1% AUSC and was obtained in <10 seconds by 51.7%, 55.2% and 62.1%, respectively.

CONCLUSION

Current methods in assessing rates below 60 bpm are inaccurate and may overestimate HR. We recommend that these methods alone should not be relied upon in neonatal resuscitation and objective assessment of heart rate should be readily available at all newborn resuscitations.

摘要

目的

确定当前心率（HR）评估方法的准确性。

方法

所有参与者触摸模拟搏动的脐部（UMB）、听取敲击速率（TAP）并听诊模拟心率（AUSC）。对所有方法随机设定模拟心率为每分钟54、88和128次心跳（bpm）。

结果

29名医护人员参与了本研究。将54 bpm的心率正确评估为在0 - 59范围内的情况，在UMB方法中占17.2%，TAP方法中占17.2%，AUSC方法中占31%；分别有48.3%、65.5%和62.1%的情况在不到10秒内得出结果。将88 bpm的心率正确评估为在60 - 100范围内的情况，在UMB方法中占82.8%，TAP方法中占79.3%，AUSC方法中占79.3%；分别有55.2%、58.6%和55.2%的情况在不到10秒内得出结果。将128 bpm的心率识别为大于100 bpm的情况，在UMB方法中占96.6%，TAP方法中占93.1%，AUSC方法中占93.1%；分别有51.7%、55.2%和62.1%的情况在不到10秒内得出结果。