Tanaka Shota, White Alexander E, Sagisaka Ryo, Chong Guanseng, Ng Eileen, Seow Jinny, Mj Nurul Asyikin, Tanaka Hideharu, Ong Marcus Eng Hock
Research Institute of Disaster management and EMS, Kokushikan University, Tokyo, Japan.
Unit for Pre-Hospital Emergency Care, Singapore General Hospital, Singapore, Singapore.
Int J Emerg Med. 2017 Dec;10(1):20. doi: 10.1186/s12245-017-0147-6. Epub 2017 Jun 24.
Mass Cardio-Pulmonary Resuscitation (CPR) training using less expensive and easily portable manikins is one way to increase the number of trained laypeople in a short time. The easy-to-carry, low-cost CPR training model called Push Heart (PH) is widely used in Japan. The aim of this study was to examine if PH can achieve chest compression quality that is similar to that using more conventional Little Anne (LA) manikins for training laypersons.
This prospective randomized crossover study was done during routine community CPR training of laypersons in Singapore. The participants were randomly allocated into two groups, using the PH and LA models respectively. They crossed over during the training so that both groups had measurements using both models. Chest compression data were collected using blinded CPRcards, which are credit card-sized devices with accelerometers and data capture. Participants did not receive any CPR feedback during measurement.
Forty-two people had data captured for the study with 15 males. The median compression depth was 41.5 mm on LA and 38.0 mm on PH (p = 0.0664), and median compression rate was 105 cpm on LA and 103 cpm on PH (p = 0.2429). Overall, only 1.5% of compressions performed on the PH achieved adequate depth of between 50-70 mm compared to 5.5% achieved on LA (p = 0.049). In contrast, 84% of all compressions performed on the PH were within the adequate rate of 100-120 cpm compared to 79.5% on LA (p = 0.457). Only the under 20-year-old group was able to achieve adequate median compression depth (50.5 mm) on LA, while the older age groups did not (p = 0.0024). The other age groups performed similar quality of chest compression regardless of the model used. 73.8% of participants preferred the LA for training. After the training, participants felt similarly well-prepared with either model with a median score of 8/10 on LA compared to 7/10 on PH (p = 0.0011).
The PH can be an alternative mass CPR training model. Both models achieved satisfactory chest compression rates, but the majority of participants, especially the elderly, had difficulty achieving adequate depth.
使用成本较低且便于携带的人体模型进行大规模心肺复苏（CPR）培训是在短时间内增加经过培训的非专业人员数量的一种方式。一种名为“按压心脏（Push Heart，PH）”的便于携带、低成本的心肺复苏培训模型在日本被广泛使用。本研究的目的是检验PH模型在培训非专业人员时，能否达到与使用更传统的小安妮（Little Anne，LA）人体模型相似的胸外按压质量。
这项前瞻性随机交叉研究在新加坡对非专业人员进行常规社区心肺复苏培训期间开展。参与者被随机分为两组，分别使用PH模型和LA模型。他们在培训过程中进行交叉，以便两组都使用两种模型进行测量。使用盲态心肺复苏卡收集胸外按压数据，盲态心肺复苏卡是带有加速度计和数据采集功能的信用卡大小的设备。参与者在测量过程中未收到任何心肺复苏反馈。
42人参与了本研究并采集到数据，其中15名男性。在LA模型上的按压深度中位数为41.5毫米，在PH模型上为38.0毫米（p = 0.0664）；在LA模型上的按压频率中位数为每分钟105次，在PH模型上为每分钟103次（p = 0.2429）。总体而言，在PH模型上进行的按压中只有1.5%达到了50 - 70毫米的足够深度，而在LA模型上这一比例为5.5%（p = 0.049）。相比之下，在PH模型上进行的所有按压中有84%的频率在每分钟100 - 120次的足够范围内，而在LA模型上这一比例为79.5%（p = 0.457）。只有20岁以下的年龄组在LA模型上能够达到足够的按压深度中位数（50.5毫米），而其他年龄组则未达到（p = 0.0024）。无论使用哪种模型，其他年龄组进行的胸外按压质量相似。73.8%的参与者更喜欢使用LA模型进行培训。培训后，参与者对两种模型培训效果的自我感觉相似，在LA模型上的中位数评分为8分（满分10分），在PH模型上为7分（满分10分）（p = 0.0011）。
PH模型可以作为一种替代的大规模心肺复苏培训模型。两种模型都能达到令人满意的胸外按压频率，但大多数参与者，尤其是老年人，难以达到足够的深度。
