Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.
Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Am J Emerg Med. 2021 Oct;48:67-72. doi: 10.1016/j.ajem.2021.03.085. Epub 2021 Mar 30.
We investigated the biomechanics of four external chest compression (ECC) approaches involving different sides of approach and hand placement during cardiopulmonary resuscitation (CPR).
A total of 60 participants (30 women and 30 men) with CPR certification performed standard continuous 2-min ECC on a Resusci Anne manikin with real-time feedback in four scenarios: rescuer at the manikin's right side with right hand chest contact (RsRc), rescuer at the manikin's right side with left hand chest contact (RsLc), rescuer at the manikin's left side with left hand chest contact (LsLc), and rescuer at the manikin's left side with right hand chest contact (LsRc). Pressure distribution maps of the palm, peak compression pressure, and compression forces were analysed.
The participants' mean age, height, and weight was 24.8 ± 4.8 years, 165.8 ± 8.7 cm, and 62.7 ± 13.5 kg, respectively. Of the participants, 58 and 2 were right- and left-handed, respectively. Significant between-scenario differences were observed in ulnar-side palm pressure. Ulnar-radial pressure differences were higher in the LsLc and RsRc groups than in the LsRc and RsLc groups (0.69 ± 0.62 and 0.73 ± 050 kg/cm vs. 0.49 ± 0.49 and 0.50 ± 0.59 kg/cm; respectively; p < 0.05). Ulnar-radial force differences were higher in the LsLc and RsRs groups than in the sLsLc and RsRs groups.
The higher differences in pressure and force under the LsLc and RsRc approaches may lead to higher risks of potential injury. When performing standard-quality ECC, the LsRc and RsLc approaches, in which compression pressure and force are better distributed, may be more suitable than RsRc or LsLc.
我们研究了四种外部胸部按压（ECC）方法的生物力学，这些方法涉及心肺复苏（CPR）期间不同的按压侧和手放置位置。
共有 60 名（30 名女性和 30 名男性）有 CPR 认证的参与者在 Resusci Anne 人体模型上进行了标准的 2 分钟连续 ECC，在四种情况下均提供实时反馈：救援者位于人体模型的右侧，右手接触胸部（RsRc）、救援者位于人体模型的右侧，左手接触胸部（RsLc）、救援者位于人体模型的左侧，左手接触胸部（LsLc）和救援者位于人体模型的左侧，右手接触胸部（LsRc）。分析了手掌的压力分布图、峰值压缩压力和压缩力。
参与者的平均年龄、身高和体重分别为 24.8 ± 4.8 岁、165.8 ± 8.7cm 和 62.7 ± 13.5kg，其中 58 人为右利手，2 人为左利手。在掌侧尺侧压力方面，各场景之间存在显著差异。与 LsRc 和 RsLc 组相比，LsLc 和 RsRc 组的尺桡侧压力差更高（0.69 ± 0.62 和 0.73 ± 050 kg/cm 与 0.49 ± 0.49 和 0.50 ± 0.59 kg/cm；p < 0.05）。在 LsLc 和 RsRs 组中，尺桡侧力差高于 LsLc 和 RsRs 组。
在 LsLc 和 RsRc 方法下，压力和力的差异较大，可能导致潜在损伤的风险更高。在进行标准质量的 ECC 时，LsRc 和 RsLc 方法中，压缩压力和力分布更好，可能比 RsRc 或 LsLc 更适合。
