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反馈对胸外按压质量的影响:一项随机模拟研究。

Effects of Feedback on Chest Compression Quality: A Randomized Simulation Study.

机构信息

Divisions of Neonatology, Pediatric Intensive Care, and Neuropediatrics, and

Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta Health Services, Edmonton, Canada.

出版信息

Pediatrics. 2019 Feb;143(2). doi: 10.1542/peds.2018-2441.

Abstract

OBJECTIVES

Our aim for this study was to test whether visual and verbal feedback compared with instructor-led feedback improve the quality of pediatric cardiopulmonary resuscitation (CPR).

METHODS

There were 653 third-year medical students randomly assigned to practice pediatric CPR on 1 of 2 manikins (infant and adolescent; = 344 and = 309, respectively). They were further randomly assigned to 1 of 3 feedback groups: The instructor feedback (IF) group ( = 225) received traditional, instructor-led feedback without any additional feedback device. The device feedback (DF) group ( = 223) received real-time visual feedback from a feedback device. The instructor and device feedback (IDF) group ( = 205) received verbal feedback from an instructor who continuously reviewed the trainees' performance using the feedback device. After the training, participants' CPR performance was assessed on the same manikin while no feedback was being provided.

RESULTS

For the primary outcome of total compression score, participants in the DF and IDF groups performed similarly, with both groups showing scores significantly ( < .001) better than those of the IF group. The same findings held for correct hand position and the proportion of complete release. For compression rate, the DF group was at the higher end of the guideline for 100 to 120 chest compressions per minute compared with the IF and IDF groups (both < .001). No effect of feedback on compression depth was found.

CONCLUSIONS

Chest compression performance significantly improved with both visual and verbal feedback compared with instructor-led feedback. Feedback devices should be implemented during pediatric resuscitation training to improve resuscitation performance.

摘要

目的

本研究旨在测试视觉和口头反馈与指导反馈相比是否能提高儿科心肺复苏术(CPR)的质量。

方法

共有 653 名三年级医学生被随机分配到 2 个复苏模型(婴儿和青少年;n=344 和 n=309)上练习儿科 CPR。他们进一步被随机分配到 3 个反馈组中的 1 个:指导反馈(IF)组(n=225)接受传统的、无任何额外反馈设备的指导反馈。设备反馈(DF)组(n=223)接受来自反馈设备的实时视觉反馈。指导和设备反馈(IDF)组(n=205)接受指导者的口头反馈,指导者使用反馈设备不断审查学员的表现。在培训后,参与者在没有提供反馈的情况下在相同的模型上评估他们的 CPR 表现。

结果

对于总按压评分的主要结局,DF 组和 IDF 组的表现相似,两组的评分均明显(<0.001)优于 IF 组。正确的手位和完全释放的比例也有相同的发现。对于按压频率,DF 组的 100 到 120 次/分钟的按压频率高于 IF 组和 IDF 组(均<0.001)。反馈对按压深度没有影响。

结论

与指导反馈相比,视觉和口头反馈都显著提高了胸外按压的表现。反馈设备应在儿科复苏培训中实施,以提高复苏表现。

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