Pechaksorn Nutthapong, Vattanavanit Veerapong
Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Critical Care Medicine Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Emerg Med Int. 2020 Sep 1;2020:5479209. doi: 10.1155/2020/5479209. eCollection 2020.
The current basic life support guidelines recommend two-minute shifts for providing chest compressions when two rescuers are performing cardiopulmonary resuscitation. However, various studies have found that rescuer fatigue can occur within one minute, coupled with a decay in the quality of chest compressions. Our aim was to compare chest compression quality metrics and rescuer fatigue between alternating rescuers in performing one- and two-minute chest compressions.
This prospective randomized cross-over study was conducted at Songklanagarind Hospital, Hat Yai, Songkhla, Thailand. We enrolled sixth-year medical students and residents and randomly grouped them into pairs to perform 8 minutes of chest compression, utilizing both the one-minute and two-minute scenarios on a manikin. The primary end points were chest compression depth and rate. The secondary end points included rescuers' fatigue, respiratory rate, and heart rate.
One hundred four participants were recruited. Compared with participants in the two-minute group, participants in the one-minute group had significantly higher mean (standard deviation, SD) compression depth (mm) (45.8 (7.2) vs. 44.5 (7.1), =0.01) but there was no difference in the mean (SD) rate (compressions per min) (116.1 (12.5) vs. 117.8 (12.4), =0.08), respectively. The rescuers in the one-minute group had significantly less fatigue ( < 0.001) and change in respiratory rate ( < 0.001), but there was no difference in the change of heart rate (=0.59) between the two groups.
There were a significantly higher compression depth and lower rescuer fatigue in the 1-minute chest compression group compared with the 2-minute group. This trial is registered with TCTR20170823001.
当前的基本生命支持指南建议,当两名救援人员进行心肺复苏时,每两分钟轮换一次进行胸外按压。然而,多项研究发现,救援人员在一分钟内就可能出现疲劳,同时胸外按压质量也会下降。我们的目的是比较在进行一分钟和两分钟胸外按压时,交替救援人员的胸外按压质量指标和救援人员疲劳程度。
这项前瞻性随机交叉研究在泰国宋卡府合艾市的宋卡纳加拉医院进行。我们招募了六年级医学生和住院医师,并将他们随机配对,在模拟人上分别采用一分钟和两分钟的方案进行8分钟的胸外按压。主要终点是胸外按压深度和频率。次要终点包括救援人员的疲劳程度、呼吸频率和心率。
共招募了104名参与者。与两分钟组的参与者相比,一分钟组的参与者平均(标准差,SD)按压深度(毫米)显著更高(45.8(7.2)对44.5(7.1),P = 0.01),但平均(SD)频率(每分钟按压次数)没有差异(116.1(12.5)对117.8(12.4),P = 0.08)。一分钟组的救援人员疲劳程度显著更低(P < 0.001),呼吸频率变化也显著更低(P < 0.001),但两组之间心率变化没有差异(P = 0.59)。
与两分钟组相比,一分钟胸外按压组的按压深度显著更高,救援人员疲劳程度更低。本试验已在泰国临床试验注册中心注册,注册号为TCTR20170823001。