使用 Capnography 和心肺复苏反馈设备的院前高级生命支持提供者。

Use of Capnography and Cardiopulmonary Resuscitation Feedback Devices Among Prehospital Advanced Life Support Providers.

机构信息

From the Division of Pediatric Emergency Medicine, Children's Hospital of Geneva, Geneva University Hospitals, Geneva, Switzerland.

Division of Pediatric Emergency Medicine, Morgan Stanley Children's Hospital of New York, Columbia University Medical Center, New York, NY.

出版信息

Pediatr Emerg Care. 2020 Dec;36(12):582-585. doi: 10.1097/PEC.0000000000001685.

DOI:10.1097/PEC.0000000000001685

PMID:30601348

Abstract

BACKGROUND

Capnography and cardiopulmonary resuscitation (CPR) feedback devices have been shown to improve resuscitation outcomes, with the American Heart Association recommending their use during advanced life support (ALS). Little is known about the availability of these devices, their protocoled use, and the attitudes toward them in the prehospital setting.

OBJECTIVES

The objectives of this study were to assess the availability of capnography and CPR feedback devices among prehospital ALS agencies in New York State (NYS), to describe the protocoled use of these devices, and to evaluate the attitudes of providers toward the use of these devices.

METHODS

Prehospital agencies that provide ALS services in NYS were identified using an online registry. Managers in these agencies were contacted by electronic mail and asked to complete a questionnaire regarding their agency's experience with capnography and CPR feedback devices. The questionnaire included questions on the availability of capnography and CPR feedback devices, the existence of clinical protocols for using capnography, and provider opinion on the utility of capnography and CPR feedback devices for improving pediatric resuscitation.

RESULTS

Of 710 ALS agencies, 238 (33.5%) completed the survey. Ninety-five percent and 24% of agencies reported having capnography and CPR feedback devices available aboard ambulances, respectively. Ninety-seven percent of agencies reported having capnography clinical protocols for endotracheal intubation, 63% for return of spontaneous circulation, and 54% for guiding CPR. Forty-seven percent agreed that capnography improves outcomes in the resuscitation of pediatric patients, whereas 51% of providers were neutral and 2% disagreed.

CONCLUSIONS

Capnography is available in most NYS ALS agencies surveyed. Cardiopulmonary resuscitation feedback devices are less common. Protocols for the use of capnography mainly focused on endotracheal intubation and less for the recognition of return of spontaneous circulation and for guiding CPR. Half of the providers surveyed were neutral on whether capnography improves outcomes in the resuscitation of pediatric patients.

摘要

背景

呼气末二氧化碳监测和心肺复苏反馈装置已被证明可改善复苏效果，美国心脏协会建议在高级生命支持期间使用。但对于这些设备在院前环境中的可用性、协议使用情况以及医护人员对其的态度知之甚少。

目的

本研究旨在评估纽约州（NYS）院前高级生命支持（ALS）机构中呼气末二氧化碳监测和心肺复苏反馈设备的可用性，描述这些设备的协议使用情况，并评估提供者对使用这些设备的态度。

方法

使用在线登记处确定在 NYS 提供 ALS 服务的院前机构。通过电子邮件联系这些机构的管理人员，要求他们完成一份关于其机构使用呼气末二氧化碳监测和心肺复苏反馈设备经验的问卷。问卷包括关于呼气末二氧化碳监测和心肺复苏反馈设备的可用性、使用呼气末二氧化碳监测的临床方案的存在以及提供者对呼气末二氧化碳监测和心肺复苏反馈设备在改善儿科复苏中的实用性的看法。

结果

在 710 个 ALS 机构中，有 238 个（33.5%）完成了调查。95%和 24%的机构报告说在救护车上有呼气末二氧化碳监测和心肺复苏反馈设备。97%的机构报告说有用于气管插管的呼气末二氧化碳监测临床方案，63%的机构有用于自主循环恢复的方案，54%的机构有用于指导心肺复苏的方案。47%的人认为呼气末二氧化碳监测可改善儿科患者复苏的结果，而 51%的提供者持中立态度，2%的人不同意。