Blewer Audrey L, Buckler David G, Li Jiaqi, Leary Marion, Becker Lance B, Shea Judy A, Groeneveld Peter W, Putt Mary E, Abella Benjamin S
Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA 19104, USA.
Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA 19104, USA ; School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA.
World J Emerg Med. 2015;6(4):270-6. doi: 10.5847/wjem.j.1920-8642.2015.04.004.
Survival from cardiac arrest is sensitive to the quality of delivered CPR. In 2010, updated international resuscitation guidelines emphasized deeper chest compressions and faster rates, yet it is unknown whether training laypersons using updated guidelines resulted in changed CPR performance. We hypothesized that laypersons taught CPR using the 2010 guidelines performed deeper and faster compressions than those taught using the 2005 materials.
This work represents a secondary analysis of a study conducted at eight hospitals where family members of hospitalized cardiac patients were trained in CPR. An initial cohort was trained using the 2005 guidelines, and a subsequent cohort was trained using the 2010 guideline materials. Post training, CPR skills were quantified using a recording manikin.
Between May 2009 to August 2013, 338 subjects completed the assessment. Among the subjects, 176 received 2005 training and 162 underwent 2010 training. The mean compression rate in the 2005 cohort was 87 (95%CI 83-90) per minute, and in the 2010 cohort was 86 (95%CI 83-90) per minute (P=ns), while the mean compression depth was 34 (95%CI 32-35) mm in the 2005 cohort and 46 (95%CI 44-47) mm in the 2010 cohort (P<0.01).
Training with the 2010 CPR guidelines resulted in a statistically significant increase in trainees' compression depth but there was no change in compression rate. Nevertheless, the majority of CPR performed by trainees in both cohorts was below the guideline recommendation, highlighting an important gap between training goals and trainee performance.
心脏骤停后的存活情况对实施的心肺复苏(CPR)质量很敏感。2010年,更新后的国际复苏指南强调进行更深的胸外按压和更快的按压速率,但使用更新后的指南培训非专业人员是否会导致CPR操作的改变尚不清楚。我们假设,使用2010年指南接受CPR培训的非专业人员比使用2005年资料接受培训的人员按压更深且更快。
本研究是对在八家医院开展的一项研究的二次分析,在这些医院中,住院心脏病患者的家属接受了CPR培训。最初的队列使用2005年指南进行培训,随后的队列使用2010年指南资料进行培训。培训后,使用记录人体模型对CPR技能进行量化。
在2009年5月至2013年8月期间,338名受试者完成了评估。其中,176人接受了2005年培训,162人接受了2010年培训。2005年队列的平均按压速率为每分钟87次(95%置信区间83 - 90),2010年队列的平均按压速率为每分钟86次(95%置信区间83 - 90)(P = 无显著差异),而2005年队列的平均按压深度为34毫米(95%置信区间32 - 35),2010年队列的平均按压深度为46毫米(95%置信区间44 - 47)(P < 0.01)。
使用2010年CPR指南进行培训使受训者的按压深度有统计学意义的增加,但按压速率没有变化。然而,两个队列中受训者进行的大多数CPR操作都低于指南建议,凸显了培训目标与受训者表现之间的重要差距。