Lyngby Rasmus Meyer, Clark Lyra, Kjoelbye Julie Samsoee, Oelrich Roselil Maria, Silver Annemarie, Christensen Helle Collatz, Barfod Charlotte, Lippert Freddy, Nikoletou Dimitra, Quinn Tom, Folke Fredrik
Copenhagen Emergency Medical Services, Copenhagen, Denmark.
Kingston University and St. Georges, University of London, London, United Kingdom.
Resusc Plus. 2021 Jan 30;5:100082. doi: 10.1016/j.resplu.2021.100082. eCollection 2021 Mar.
To investigate whether real-time ventilation feedback would improve provider adherence to ventilation guidelines.
Non-blinded randomised controlled simulation trial.
One Emergency Medical Service trust in Copenhagen.
32 ambulance crews consisting of 64 on-duty basic or advanced life support paramedics from Copenhagen Emergency Medical Service.
Participant exposure to real-time ventilation feedback during simulated out-of-hospital cardiac arrest.
The primary outcome was ventilation quality, defined as ventilation guideline-adherence to ventilation rate (8-10 bpm) and tidal volume (500-600 ml) delivered simultaneously.
The intervention group performed ventilations in adherence with ventilation guideline recommendations for 75.3% (Interquartile range (IQR) 66.2%-82.9%) of delivered ventilations, compared to 22.1% (IQR 0%-44.0%) provided by the control group. When controlling for participant covariates, adherence to ventilation guidelines was 44.7% higher in participants receiving ventilation feedback. Analysed separately, the intervention group performed a ventilation guideline-compliant rate in 97.4% (IQR 97.1%-100%) of delivered ventilations, versus 66.7% (IQR 40.9%-77.9%) for the control group. For tidal volume compliance, the intervention group reached 77.5% (IQR 64.9%-83.8%) of ventilations within target compared to 53.4% (IQR 8.4%-66.7%) delivered by the control group.
Real-time ventilation feedback increased guideline compliance for both ventilation rate and tidal volume (combined and as individual parameters) in a simulated OHCA setting. Real-time feedback has the potential to improve manual ventilation quality and may allow providers to avoid harmful hyperventilation.
探讨实时通气反馈是否会提高医护人员对通气指南的遵循情况。
非盲随机对照模拟试验。
哥本哈根的一个紧急医疗服务信托机构。
32个救护小组，由来自哥本哈根紧急医疗服务机构的64名值班基础或高级生命支持护理人员组成。
参与者在模拟院外心脏骤停期间接受实时通气反馈。
主要结局为通气质量，定义为同时遵循通气指南的通气频率（8 - 10次/分钟）和潮气量（500 - 600毫升）。
干预组所进行的通气中有75.3%（四分位间距（IQR）66.2% - 82.9%）符合通气指南建议，而对照组为22.1%（IQR 0% - 44.0%）。在控制参与者协变量后，接受通气反馈的参与者对通气指南的遵循率高出44.7%。单独分析时，干预组所进行的通气中有97.4%（IQR 97.1% - 100%）符合通气指南，而对照组为66.7%（IQR 40.9% - 77.9%）。对于潮气量的符合情况，干预组有77.5%（IQR 64.9% - 83.8%）的通气在目标范围内，而对照组为53.4%（IQR 8.4% - 66.7%）。
在模拟院外心脏骤停环境中，实时通气反馈提高了通气频率和潮气量（综合及作为单独参数）的指南遵循率。实时反馈有可能改善人工通气质量，并可能使医护人员避免有害的过度通气。
