Department of Anesthesia, Intensive Care, Emergency and Pain Medicine, Kreiskrankenhaus Mechernich GmbH, Mechernich, Germany -
Minerva Anestesiol. 2016 Apr;82(4):429-37. Epub 2015 Nov 17.
Physical and mental workload during cardiopulmonary resuscitation (CPR) is challenging under extreme working conditions. We hypothesized that the mechanical chest-compression device Lund University Cardiac Assist System (LUCAS) increases the effectiveness of CPR, decreases the physical workload and improves the mental performance of the emergency medical service (EMS) staff during simulated emergency helicopter flights.
During simulated helicopter flights, 12 EMS teams performed manual or LUCAS-CPR on a manikin at random order. Compression depth, rate, overall time of compressions, application of drugs and defibrillation were recorded to test the quality of CPR. Heart rate monitoring of EMS members was used as a surrogate of physical workload. Cognitive performance was evaluated shortly after each flight by a questionnaire and a memory test about medical and extraneous items presented to the teams during the flights.
Overall times of chest-compressions were similar, compression rate (101.7±9.6/min) was lower and compressions were deeper (3.9±0.2cm) with LUCAS as compared to manual CPR (113.3±19.3/min and 3.7±0.4cm) (P<0.01, respectively). Heart rates of the EMS staff were increased after manual as compared to mechanical CPR (100.1±21.0 vs. 80.4±11.3, P<0.01). Results of the questionnaire (93.6±6.9% vs. 87.0±7.3% correct answers, P<0.01) and memory test (22.4±15.4% vs. 11.3±7.5%, P<0.02) were significantly better after LUCAS resuscitation. Dosing of drugs, application intervals and rate of correct handling of drugs and defibrillation were not different between LUCAS or manual CPR.
During simulated helicopter flights LUCAS-CPR improved the efficacy of chest-compressions, was physically less demanding and provided enhanced cognitive performance of the EMS team as compared to manual CPR.
心肺复苏术(CPR)期间的身心工作量在极端工作条件下具有挑战性。我们假设 Lund 大学心脏辅助系统(LUCAS)机械胸部按压设备可提高 CPR 的效果,降低身体工作量并提高紧急医疗服务(EMS)人员在模拟紧急直升机飞行期间的精神表现。
在模拟直升机飞行期间,12 个 EMS 团队以随机顺序对模拟人进行手动或 LUCAS-CPR。记录按压深度、速率、总按压时间、药物应用和除颤以测试 CPR 的质量。通过心率监测器监测 EMS 成员的心率,作为身体工作量的替代指标。飞行后不久,通过问卷和有关飞行过程中向团队展示的医学和无关项目的记忆测试来评估认知表现。
总体按压时间相似,但与手动 CPR(113.3±19.3/min 和 3.7±0.4cm)相比,LUCAS 的按压速率(101.7±9.6/min)更低,按压更深(3.9±0.2cm)(P<0.01)。与机械 CPR 相比,EMS 工作人员的心率在手动 CPR 后升高(100.1±21.0 与 80.4±11.3,P<0.01)。问卷(93.6±6.9% 与 87.0±7.3%正确答案,P<0.01)和记忆测试(22.4±15.4%与 11.3±7.5%,P<0.02)的结果在 LUCAS 复苏后明显更好。LUCAS 或手动 CPR 之间药物剂量、应用间隔以及药物和除颤正确处理率没有差异。
与手动 CPR 相比,在模拟直升机飞行中,LUCAS-CPR 可提高胸部按压的效果,对身体的要求较低,并且提高了 EMS 团队的认知表现。