标准培训与电话基础生命支持培训项目对中老年家庭主妇心肺复苏质量的比较：一项随机模拟研究

Comparison of Cardiopulmonary Resuscitation Quality Between Standard Versus Telephone-Basic Life Support Training Program in Middle-Aged and Elderly Housewives: A Randomized Simulation Study.

作者信息

Kim Tae Han, Lee Yu Jin, Lee Eui Jung, Ro Young Sun, Lee KyungWon, Lee Hyeona, Jang Dayea Beatrice, Song Kyoung Jun, Shin Sang Do, Myklebust Helge, Birkenes Tonje Søraas

机构信息

From the Department of Emergency Medicine (T.H.K.), Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul; Department of Emergency Medicine (Y.J.L.), Inha University Hospital, Incheon; Department of Emergency Medicine (E.J.L.), Korea University Anam Hospital; Laboratory of Emergency Medical Services (Y.S.R., H.L., D.B.J.), Seoul National University Hospital Biomedical Research Institute; Department of Emergency Medicine (K.W.L.), Inje University College of Medicine and Seoul Paik Hospital; Department of Emergency Medicine (K.J.S., S.D.S.), Seoul National University College of Medicine, Seoul, Korea; and Laerdal Medical (H.M., T.S.B.), Stavanger, Norway.

出版信息

Simul Healthc. 2018 Feb;13(1):27-32. doi: 10.1097/SIH.0000000000000286.

DOI:10.1097/SIH.0000000000000286

PMID:29369963

Abstract

INTRODUCTION

For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs.

METHODS

Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs. The T-BLS training program included concepts and current instruction protocols for telephone-assisted CPR, whereas the S-BLS training program provided training for BLS. After each training course, the participants simulated CPR and were assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality was measured and recorded using a mannequin simulator. The primary outcome was total no-flow time (>1.5 seconds without chest compression) during simulation.

RESULTS

Among 24 participants, two (8.3%) who experienced mechanical failure of simulation mannequin and one (4.2%) who violated simulation protocols were excluded at initial simulation, and two (8.3%) refused follow-up after 6 months. The median (interquartile range) total no-flow time during initial simulation was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6 (122.5-184.0) seconds for the S-BLS training group (P < 0.01). Median cumulative interruption time and median number of interruption events during BLS at initial simulation and 6-month follow-up simulation were significantly shorter in the T-BLS than in the S-BLS group (1.0 vs. 9.5, P < 0.01, and 1.0 vs. 10.5, P = 0.02, respectively).

CONCLUSIONS

Participants trained with the T-BLS training program showed shorter no-flow time and fewer interruptions during bystander CPR simulation assisted by a dispatcher.

摘要

引言

对于在家中发生的心脏骤停事件，目击者通常是中年或老年家庭主妇。我们比较了接受新开发的电话基础生命支持（T-BLS）计划培训的旁观者与接受标准基础生命支持（S-BLS）培训计划培训的旁观者的心肺复苏（CPR）操作质量。

方法

招募24名此前未接受过心肺复苏培训的中年及老年家庭主妇，并随机分为两组基础生命支持培训计划。T-BLS培训计划包括电话辅助心肺复苏的概念和当前指导方案，而S-BLS培训计划提供基础生命支持培训。每次培训课程后，参与者模拟心肺复苏，并由调度员通过电话提供协助。使用人体模型模拟器测量并记录心肺复苏质量。主要结局是模拟过程中的总无按压时间（胸部按压中断超过1.5秒）。

结果

在24名参与者中，两名（8.3%）模拟人体模型出现机械故障，一名（4.2%）违反模拟方案，在初始模拟时被排除，两名（8.3%）在6个月后拒绝随访。T-BLS培训组在初始模拟时的总无按压时间中位数（四分位间距）为79.6（66.4-96.9）秒，S-BLS培训组为147.6（122.5-184.0）秒（P<0.01）。在初始模拟和6个月随访模拟中，T-BLS组基础生命支持期间的累积中断时间中位数和中断事件中位数均显著短于S-BLS组（分别为1.0对9.5，P<0.01；1.0对10.5，P=0.02）。