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比较冲浪救生员和麻醉护士对i-gel声门上气道装置的使用——一项观察性模拟研究。

Comparing Surf Lifeguards and Nurse Anesthetists' Use of the i-gel Supraglottic Airway Device - An Observational Simulation Study.

作者信息

Nørkjær Louise, Stærk Mathilde, Lauridsen Kasper G, Gallacher Tabita K, Løyche Jakob B, Krogh Kristian, Løfgren Bo

机构信息

Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.

Clinical Research Unit, Randers Regional Hospital, Randers, Denmark.

出版信息

Open Access Emerg Med. 2020 Apr 2;12:73-79. doi: 10.2147/OAEM.S239040. eCollection 2020.

Abstract

PURPOSE

Using a supraglottic airway (SGA) may provide more effective ventilations compared with a mouth-to-pocket-mask for drowning victims. SGAs are widely used by nurse anesthetists but it is unknown whether surf lifeguards can use SGAs effectively. We aimed to compare the use of SGA by surf lifeguards and experienced nurse anesthetists.

MATERIALS AND METHODS

Surf lifeguards inserted a SGA (i-gel O, size 4) in a resuscitation manikin during cardiopulmonary resuscitation (CPR) and nurse anesthetists inserted a SGA in a resuscitation manikin placed on a bed, and performed ventilations. Outcome measures: time to first ventilation, tidal volume, proportion of ventilations with visible manikin chest rise, and ventilations within the recommended tidal volume (0.5-0.6 L).

RESULTS

Overall, 30 surf lifeguards and 30 nurse anesthetists participated. Median (Q1-Q3) time to first ventilation was 20 s (15-22) for surf lifeguards and 17 s (15-21) for nurse anesthetists (=0.31). Mean (SD) tidal volume was 0.55 L (0.21) for surf lifeguards and 0.31 L (0.10) for nurse anesthetists (<0.0001). Surf lifeguards and nurse anesthetists delivered 100% and 95% ventilations with visible manikin chest rise (=0.004) and 19% and 5% ventilations within the recommended tidal volume, respectively (<0.0001).

CONCLUSION

In a simulated setting, there was no significant difference between surf lifeguards and experienced nurse anesthetists in time to first ventilation when using a SGA. Surf lifeguards delivered a higher tidal volume, and a higher proportion of ventilations within guideline recommendations, but generally ventilations caused visible manikin chest rise for both groups.

摘要

目的

与口对口面罩相比,使用声门上气道(SGA)对溺水受害者进行通气可能更有效。SGA被麻醉护士广泛使用,但尚不清楚冲浪救生员是否能有效地使用SGA。我们旨在比较冲浪救生员和经验丰富的麻醉护士使用SGA的情况。

材料与方法

在心肺复苏(CPR)期间,冲浪救生员将一个SGA(i-gel O,4号尺寸)插入复苏人体模型中,麻醉护士将一个SGA插入放置在床上的复苏人体模型中,并进行通气。观察指标:首次通气时间、潮气量、通气时人体模型胸部可见隆起的比例以及在推荐潮气量(0.5-0.6L)内的通气次数。

结果

总体上,30名冲浪救生员和30名麻醉护士参与了研究。冲浪救生员首次通气的中位时间(四分位间距)为20秒(15-22秒),麻醉护士为17秒(15-21秒)(P=0.31)。冲浪救生员的平均(标准差)潮气量为0.55L(0.21),麻醉护士为0.31L(0.10)(P<0.0001)。冲浪救生员和麻醉护士通气时人体模型胸部可见隆起的比例分别为100%和95%(P=0.004),在推荐潮气量内的通气比例分别为19%和5%(P<0.0001)。

结论

在模拟环境中,使用SGA时,冲浪救生员和经验丰富的麻醉护士在首次通气时间上没有显著差异。冲浪救生员的潮气量更高,且在指南建议范围内的通气比例更高,但两组通气时通常都会使人体模型胸部可见隆起。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ed/7135198/f7a29237f1d0/OAEM-12-73-g0001.jpg

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