Root Christopher W, Deutsch Brian C, Lakha Sameer, Shah Anjan, Lin Hung Mo, Hyman Jaime B
Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
J Emerg Med. 2019 Jul;57(1):51-58. doi: 10.1016/j.jemermed.2019.03.009. Epub 2019 May 3.
Cardiopulmonary resuscitation (CPR) requires effective chest compressions and ventilations to circulate and oxygenate blood. It has been established that a 2-handed mask seal is superior when providing bag-valve-mask (BVM) ventilations. However a 1-handed technique remains the standard with which health care providers are trained to perform 2-rescuer CPR.
We sought to determine if a modified 2-rescuer CPR technique that incorporates a 2-handed mask seal during ventilations can be accomplished without compromising chest compression quality during a simulated cardiac arrest.
Medical student volunteers were divided into an "intervention" arm, with 1 rescuer creating a 2-handed mask seal and the second rescuer performing chest compressions followed by that second rescuer squeezing the BVM bag to deliver ventilations during compression pauses, and a "control" arm, in which standard 2-rescuer CPR was performed. Both arms received a brief CPR refresher following a standard script. The 2 rescuer teams then performed 2 rounds of CPR on a manikin while being video recorded. Data were collected from real-time evaluation and post hoc video analysis.
Forty-seven pairs of students enrolled in the study. There were no statistically significant differences between the intervention and control arms for median (interquartile range [IQR]) compression fraction (72% [69.5-75.7%] vs. 73.2% [69.1-76.1%]; p = 1.0), median time to complete 2 rounds of CPR (207.8 s [198.5-222.9 s] vs. 214.7 s [201.3-219.5 s]; p = 0.625), median hands-off time (49.8 s [46.2-63.0 s] vs. 55.4 s [50.4-65.2 s]; p = 0.278), or median time for 30 compressions (15.2 s [14.3-15.9 s] vs. 15.4 s [14.6-16.3 s]; p = 0.452).
Two-rescuer CPR incorporating a 2-handed face mask seal can be performed effectively without impacting chest compression quality during simulated cardiac arrest.
心肺复苏（CPR）需要有效的胸外按压和通气，以使血液循环并进行氧合。已经证实，在进行袋阀面罩（BVM）通气时，双手面罩密封法更具优势。然而，单手技术仍然是医护人员接受双人CPR培训的标准方法。
我们试图确定在模拟心脏骤停期间，一种在通气时采用双手面罩密封法的改良双人CPR技术，能否在不影响胸外按压质量的情况下完成。
将医学生志愿者分为“干预”组，一名施救者采用双手面罩密封法，另一名施救者进行胸外按压，然后第二名施救者在按压间隙挤压BVM气囊进行通气；以及“对照组”，进行标准的双人CPR。两组均按照标准脚本接受简短的CPR复习培训。然后，双人施救小组在模拟人上进行两轮CPR，并进行视频录制。数据通过实时评估和事后视频分析收集。
47对学生参与了该研究。干预组和对照组在中位（四分位间距[IQR]）按压比例（72%[69.5 - 75.7%]对73.2%[69.1 - 76.1%]；p = 1.0）、完成两轮CPR的中位时间（207.8秒[198.5 - 222.9秒]对214.7秒[201.3 - 219.5秒]；p = 0.625）、中位手离开时间（49.8秒[46.2 - 63.0秒]对55.4秒[50.4 - 65.2秒]；p = 0.278）或30次按压的中位时间（15.2秒[14.3 - 15.9秒]对15.4秒[14.6 - 16.3秒]；p = 0.452）方面，均无统计学显著差异。
在模拟心脏骤停期间，采用双手面罩密封法的双人CPR能够有效进行，且不影响胸外按压质量。
