Critical Care Unit, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Critical Care Unit, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Resuscitation. 2019 Sep;142:91-96. doi: 10.1016/j.resuscitation.2019.07.016. Epub 2019 Jul 19.
Cardiopulmonary resuscitation (CPR) guidelines vary in the terminology used to describe target chest compression depth, which may impact CPR quality. We investigated the impact of using different chest compression depth instruction terminologies on CPR quality.
We conducted a parallel group, three-arm, randomised controlled manikin trial in which individuals without recent CPR training were instructed to deliver compression-only CPR for 2-min based on a standardised dispatcher-assisted CPR script. Participants were randomised in a 1:1:1 ratio to receive CPR delivery instructions that instructed them to deliver chest compressions based on the following terminologies: 'press at least 5 cm', 'press approximately 5 cm' or 'press hard and fast.' The primary outcome was compression depth, measured in millimetres.
Between October 2017 and June 2018, 330 participants were randomised to 'at least 5 cm' (n = 109), 'approximately 5 cm' (n = 110) and 'hard and fast' (n = 111), in which mean chest compression depth was 40.9 mm (SD 13.8), 35.4 mm (SD 14.1), and 46.8 mm (SD 15.0) respectively. Mean difference in chest compression depth between 'at least 5 cm' and 'approximately 5 cm' was 5.45 (95% confidence interval (95% CI) 0.78-10.12), between 'hard and fast' and 'approximately 5 cm' was 11.32 (95% CI 6.65-15.99), and between 'hard and fast' and 'at least 5 cm' was 5.87 (95% CI 1.21-10.53). Chest compression rate and count were both highest in the 'hard and fast' group.
The use of 'hard and fast' terminology was superior to both 'at least 5 cm' and 'approximately 5 cm' terminologies.
ISRCTN15128211.
心肺复苏（CPR）指南中用于描述目标胸外按压深度的术语存在差异，这可能会影响 CPR 质量。我们研究了使用不同的胸外按压深度指导术语对 CPR 质量的影响。
我们进行了一项平行组、三臂、随机对照模拟试验，其中没有近期 CPR 培训的个体根据标准化调度员辅助 CPR 脚本进行 2 分钟的仅按压式 CPR。参与者以 1:1:1 的比例随机分配，接受以下术语的 CPR 实施指导：“按压至少 5cm”、“按压约 5cm”或“快速有力地按压”。主要结局是测量的按压深度，单位为毫米。
2017 年 10 月至 2018 年 6 月期间，330 名参与者被随机分配至“至少 5cm”（n=109）、“约 5cm”（n=110）和“快速有力”（n=111）组，其中平均胸外按压深度分别为 40.9mm（SD 13.8）、35.4mm（SD 14.1）和 46.8mm（SD 15.0）。“至少 5cm”和“约 5cm”之间的胸外按压深度差异为 5.45mm（95%置信区间（95%CI）0.78-10.12），“快速有力”和“约 5cm”之间的差异为 11.32mm（95%CI 6.65-15.99），“快速有力”和“至少 5cm”之间的差异为 5.87mm（95%CI 1.21-10.53）。“快速有力”组的胸外按压频率和次数均最高。
“快速有力”术语的使用优于“至少 5cm”和“约 5cm”术语。
ISRCTN83440355。
