Prehosp Emerg Care. 2021 May-Jun;25(3):370-376. doi: 10.1080/10903127.2020.1754977. Epub 2020 May 7.
Stretchers are commonly used for transporting cardiac arrest patients, but their use may be limited in confined spaces, like elevators. Use of transfer sheet as an alternative has not been explored. We aimed to compare manual chest compression quality between these two methods. In this prospective, open-label, randomized cross-over manikin study, the subjects included emergency medical technicians who were assigned to 12 three-person crews. Scenarios included transport of a cardiac arrest in a high-rise building and elevator using transfer sheet (TS) and stretchers adjusted to 45° (S45) and 90° (S90). Chest compression quality was measured using a recording manikin and that before (on-scene phase) and after (transport phase) the manikin moved via transfer sheet or stretcher were compared. The final analysis included 72 simulation runs. Chest compression quality did not differ among the groups in the on-scene phase. In the transport phase, the transfer sheet group provided greater mean compression depth (54.4 ± 4.2 vs 39.6 ± 7.2 mm, p < 0.01 and 54.4 ± 4.2 vs 40.6 ± 8.3 mm, p < 0.01, respectively) than stretchers of S45 and S90, and higher percentage of deep-enough compression (TS: 51.0 [23.8-74.8]% vs S45: 19.5 [5.8-29.5]%, p < 0.01) than the S45 group. Transfer sheet use showed a trend of lower percentages of full recoil (TS: 40.0 [12.8-64.5]% vs S45: 70.5 [47.0-79.8]% vs S90: 52.5 [25.3-76.0]%, p = 0.09). Chest compression fraction, compressions with correct hand position, and mean compression rates did not differ between groups in the transport phase. The TS group showed shorter time intervals of simulation start-to-first-compression (TS: 13.9 [12.4-15.1] sec vs S90: 15.9 [13.3-16.4] sec, p = 0.04) and total run time (TS: 145.7 [135.1-151.4] sec vs S90: 160.0 [151.9-175.4] sec, p < 0.01) than the S90 group. In this simulation, using transfer sheet outperform using stretcher for transporting cardiac arrest patients from high-rise buildings. Rescuers need to be aware of full chest recoil.
担架通常用于运送心脏骤停患者，但在电梯等狭小空间内使用可能受到限制。使用转移单作为替代方法尚未得到探索。我们旨在比较这两种方法的手动胸部按压质量。 在这项前瞻性、开放标签、随机交叉式模拟研究中，研究对象包括被分配到 12 个三人小组的急救医疗技术员。场景包括使用转移单（TS）和调整至 45°（S45）和 90°（S90）的担架在高层建筑和电梯中转运心脏骤停患者。使用记录式模拟人测量胸部按压质量，并比较模拟人在转移单或担架上移动前后（现场阶段和转运阶段）的按压质量。 最终分析包括 72 次模拟运行。现场阶段，各组之间的胸部按压质量没有差异。在转运阶段，转移单组提供的平均压缩深度大于 S45 和 S90 组（54.4±4.2 比 39.6±7.2mm，p<0.01 和 54.4±4.2 比 40.6±8.3mm，p<0.01），且深度按压比例更高（TS：51.0[23.8-74.8]%比 S45：19.5[5.8-29.5]%，p<0.01）。与 S45 组相比，转移单的完全回弹比例较低（TS：40.0[12.8-64.5]%比 S45：70.5[47.0-79.8]%比 S90：52.5[25.3-76.0]%，p=0.09）。转运阶段，各组之间的胸部按压分数、手部位置正确的按压次数和平均按压率没有差异。TS 组的模拟开始至第一次按压的时间间隔更短（TS：13.9[12.4-15.1]sec 比 S90：15.9[13.3-16.4]sec，p=0.04）和总运行时间更短（TS：145.7[135.1-151.4]sec 比 S90：160.0[151.9-175.4]sec，p<0.01）。在这项模拟中，与使用 S90 相比，使用转移单运送高层建筑心脏骤停患者的效果更好。救援人员需要注意完全回弹。
