Hasegawa Tomoyuki, Okane Ritsu, Ichikawa Yoko, Inukai Sayuri, Saito Shin
Mie Prefectural College of Nursing, Tsu, Japan.
Jpn J Nurs Sci. 2020 Apr;17(2):e12314. doi: 10.1111/jjns.12314. Epub 2020 Jan 19.
Cardiopulmonary resuscitation is vital for survival after cardiac arrest, and chest compressions are an important aspect of this. When performing chest compression in a hospital setting, the rescuer often has to kneel on the bed to overcome inconvenient differences in height between the rescuer and the bed. However, as yet no study has evaluated the quality of chest compressions in this position. The aim of this study was to examine the impact on the quality of chest compressions while kneeling on the bed.
Fifteen female students performed 2-min chest compressions on a manikin placed on the floor and a bed. Measurement parameters included compression depth, heart rate, integrated electromyogram, and a visual analog scale. The parameters were measured every 30 s and were statistically compared between the conditions.
Compression depth at 30, 60, 90, and 120 s differed significantly between the conditions. Heart rate values at 150 and 210 s of recovery significantly differed between the conditions. Integrated electromyogram values for the trapezius, rectus femoris, and biceps femoris differed between the floor and bed conditions during 2-min chest compressions, whereas the external oblique muscle significantly differed at 60 and 120 s. Visual analog scales for fatigue, effectiveness, and stability significantly differed between the conditions.
Kneeling on the bed does not enable grounding of the toe, causing the upper body to be unstable and limiting generation of the power required for chest compression. Our results suggest that rotation every minute is necessary to maintain effective cardiopulmonary resuscitation while kneeling on the bed.
心肺复苏对于心脏骤停后的生存至关重要，而胸外按压是其中的一个重要方面。在医院环境中进行胸外按压时，施救者常常不得不跪在床上来克服自身与床之间不方便的高度差。然而，尚无研究评估过在这种姿势下胸外按压的质量。本研究的目的是考察跪在床上对胸外按压质量的影响。
15名女学生在放置于地面和床上的人体模型上进行2分钟的胸外按压。测量参数包括按压深度、心率、肌电图积分以及视觉模拟评分。每隔30秒测量一次参数，并对不同条件下的参数进行统计学比较。
不同条件下30、60、90和120秒时的按压深度存在显著差异。恢复过程中150和210秒时的心率值在不同条件下有显著差异。在2分钟胸外按压过程中，地面和床两种条件下斜方肌、股直肌和股二头肌的肌电图积分值有所不同，而腹外斜肌在60和120秒时存在显著差异。不同条件下疲劳、有效性和稳定性的视觉模拟评分有显著差异。
跪在床上无法使脚趾着地，导致上半身不稳定，并限制了胸外按压所需力量的产生。我们的结果表明，跪在床上进行有效的心肺复苏时每分钟轮换姿势是必要的。
