Nakashima Yukako, Saitoh Takeji, Yasui Hideki, Ueno Masahide, Hotta Kensuke, Ogawa Takashi, Takahashi Yoshiaki, Maekawa Yuichiro, Yoshino Atsuto
Department of Emergency and Disaster Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3125, Japan.
Department of Cardiology, Hamamatsu University School of Medicine, Hamamatsu 431-3125, Japan.
J Clin Med. 2020 May 23;9(5):1584. doi: 10.3390/jcm9051584.
When a rescuer walks alongside a stretcher and compresses the patient's chest, the rescuer produces low-quality chest compressions. We hypothesized that a stretcher equipped with wing boards allows for better chest compressions than the conventional method.
In this prospective, randomized, crossover study, we enrolled 45 medical workers and students. They performed hands-on chest compressions to a mannequin on a moving stretcher, while either walking (the walk method) or riding on wings attached to the stretcher (the wing method). The depths of the chest compressions were recorded. The participants' vital signs were measured before and after the trials.
The average compression depth during the wing method (5.40 ± 0.50 cm) was greater than during the walk method (4.85 ± 0.80 cm; < 0.01). The average compression rates during the two minutes were 215 ± 8 and 217 ± 5 compressions in the walk and wing methods, respectively ( = ns). Changes in blood pressure (14 ± 11 vs. 22 ± 14 mmHg), heart rate (32 ± 13 vs. 58 ± 20 bpm), and modified Borg scale (4 (interquartile range: 2-4) vs. 6 (5-7)) were significantly lower in the wing method cohort compared to the walking cohort ( < 0.01). The rescuer's size and physique were positively correlated with the chest compression depth during the walk method; however, we found no significant correlation in the wing method.
Chest compressions performed on the stretcher while moving using the wing method can produce high-quality chest compressions, especially for rescuers with a smaller size and physique.
当救援人员在担架旁行走并按压患者胸部时,救援人员进行的胸外按压质量较低。我们假设配备翼板的担架比传统方法能进行更好的胸外按压。
在这项前瞻性、随机、交叉研究中,我们招募了45名医务人员和学生。他们在移动的担架上对人体模型进行实际胸外按压,分别采用行走(行走法)或骑在担架上的翼板上(翼板法)。记录胸外按压的深度。在试验前后测量参与者的生命体征。
翼板法期间的平均按压深度(5.40±0.50厘米)大于行走法期间的平均按压深度(4.85±0.80厘米;<0.01)。行走法和翼板法在两分钟内的平均按压频率分别为215±8次和217±5次按压(=无显著性差异)。与行走组相比,翼板法组的血压变化(14±11对22±14毫米汞柱)、心率变化(32±13对58±20次/分钟)和改良博格量表变化(4(四分位间距:2 - 4)对6(5 - 7))显著更低(<0.01)。在行走法期间,救援人员的体型和体格与胸外按压深度呈正相关;然而,在翼板法中我们未发现显著相关性。
使用翼板法在移动担架上进行胸外按压可产生高质量的胸外按压,尤其对于体型较小和体格较弱的救援人员。