Lee Kwangchun, Kim Min Joung, Park Junseok, Park Joon Min, Kim Kyung Hwan, Shin Dong Wun, Kim Hoon, Jeon Woochan, Kim Hyunjong
Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2017 Oct;96(43):e8268. doi: 10.1097/MD.0000000000008268.
In the clinical setting, the dispersed practitioners' attention often leads to decreased competence in their performance. We aimed to investigate the effect of distracted practitioners on the quality of chest compression during cardiopulmonary resuscitation.
A randomized controlled crossover simulation study was conducted. Participants were recruited from among doctors, nurses, and paramedics working in a university tertiary hospital. The paced auditory serial addition test (PASAT) was used as a tool for distracting participants. In the crossover design, each participant played 2 scenarios with a 20-minute time gap, by a random order; 2-minute continuous chest compressions with and without PASAT being conducted. The primary outcome was the percentage of compression with an adequate compression rate. Secondary outcomes were the percentage of compression with adequate depth, the percentage of compression with full chest wall recoil, mean compression rate (per minute), mean compression depth, and subjective difficulty of chest compression.
Forty-four participants were enrolled, and all of them completed the study. It was found that the percentage of compression with an adequate compression rate was lower when the PASAT was conducted. Although there was no difference in the percentage of compression with adequate depth (P = .88), the percentage of compression with complete chest recoil was lower when PASAT was conducted. In addition, while the mean compression rate was higher when PASAT was conducted, the mean compression depth was not significantly different (P = .65). The subjective difficulty was not different (P = .69).
Health care providers who are distracted have a negative effect on the quality of chest compression, in terms of its rate and chest wall recoil.
www.ClinicalTrials.gov, NCT03124290.
在临床环境中，从业者注意力分散往往会导致其操作能力下降。我们旨在研究注意力分散的从业者对心肺复苏期间胸外按压质量的影响。
进行了一项随机对照交叉模拟研究。参与者从一家大学三级医院工作的医生、护士和护理人员中招募。采用听觉连续加法测验（PASAT）作为分散参与者注意力的工具。在交叉设计中，每位参与者以随机顺序在两个场景中进行操作，间隔20分钟；分别在有和没有PASAT干扰的情况下进行2分钟的持续胸外按压。主要结局是按压速率合适的按压百分比。次要结局包括按压深度合适的按压百分比、胸壁完全回弹的按压百分比、平均按压速率（每分钟）、平均按压深度以及胸外按压的主观难度。
共招募了44名参与者，他们均完成了研究。结果发现，进行PASAT时，按压速率合适的按压百分比更低。虽然按压深度合适的按压百分比没有差异（P = 0.88），但进行PASAT时胸壁完全回弹的按压百分比更低。此外，虽然进行PASAT时平均按压速率更高，但平均按压深度没有显著差异（P = 0.65）。主观难度没有差异（P = 0.69）。
注意力分散的医护人员在胸外按压的速率和胸壁回弹方面对胸外按压质量有负面影响。
