Zalewski Radosław, Puślecki Mateusz, Szarpak Łukasz, Kłosiewicz Tomasz, Dąbrowski Marek, Perek Bartłomiej
Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Collegium Adama Wrzoska Rokietnicka Street 7, Poznan 60-806, Poland.
Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Dluga Street 1/2, Poznan 61-848, Poland.
Emerg Med Int. 2020 Oct 19;2020:2675214. doi: 10.1155/2020/2675214. eCollection 2020.
Early defibrillation and high-quality chest compressions are crucial in treatment of sudden cardiac arrest (SCA) subjects. The aim of this study was to assess an impact of defibrillation methods on cardiopulmonary resuscitation (CPR) quality.
A randomized simulation cross-study was designed, in which 100 two-person paramedical teams participated. Two 10-minute scenarios of SCA in the mechanism of ventricular fibrillation were analysed. In the first one, teams had at their disposal defibrillator with hard paddles (group C), whereas in the second one, adhesive electrodes were used (group MFE). The CPR quality was evaluated on the basis of the chest compression parameters (rate, depth, recoil, compression fraction (CCF), and no-flow time), airways patency achievement, and successful emergency drug administration.
Substituting standard hard paddles with adhesive electrodes led to an increase in CCF (77% vs 73%; < 0.05), higher rate of complete chest recoil, and a decrease in no-flow time (6.0 ± 1.1 vs. 7.3 ± 1.1; < 0.001). The airway patency was ensured sooner in group MFE (271 ± 118 s vs. 322 ± 106 s in group C; < 0.001). All teams in scenario with adhesive electrodes were able to administer two doses of adrenaline, meanwhile only 74% of them in group C ( < 0.001). Moreover, in 8% of group C scenarios, paramedics did not have enough time to administer amiodarone.
Our simulation-based analysis revealed that use of adhesive electrodes during defibrillation instead of standard hard paddles may improve the quality of CPR performed by two-person emergency team.
早期除颤和高质量胸外按压对心脏骤停（SCA）患者的治疗至关重要。本研究的目的是评估除颤方法对心肺复苏（CPR）质量的影响。
设计了一项随机模拟交叉研究，100个两人急救小组参与其中。分析了两个10分钟的室颤机制心脏骤停场景。在第一个场景中，小组可使用带有硬电极板的除颤器（C组），而在第二个场景中，使用粘性电极（MFE组）。根据胸外按压参数（速率、深度、回弹、按压分数（CCF）和无血流时间）、气道通畅情况以及成功进行紧急药物给药来评估CPR质量。
用粘性电极替代标准硬电极板导致CCF增加（77%对73%；<0.05），完全胸外回弹率更高，无血流时间减少（6.0±1.1对7.3±1.1；<0.001）。MFE组更快确保气道通畅（MFE组为271±118秒，C组为322±106秒；<0.001）。使用粘性电极场景中的所有小组都能够给予两剂肾上腺素，而C组中只有74%的小组能够做到（<0.001）。此外，在C组8%的场景中，急救人员没有足够时间给予胺碘酮。
我们基于模拟的分析表明，除颤时使用粘性电极而非标准硬电极板可能会提高两人急救小组进行的CPR质量。
