医护人员特征与婴儿复苏中的心肺复苏质量：一项模拟研究。

Healthcare Provider Characteristics and Cardiopulmonary Resuscitation Quality During Infant Resuscitation: A Simulation Study.

机构信息

From the Division of Neonatology (M.K.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Department of Anesthesiology (K.F.), Mälarsjukhuset Hospital; Department of Anesthesiology (K.F.), Mälarsjukhuset/Karolinska Institutet, Eskilstuna, Sweden; Faculty of Biology, Medicine and Health (R.M.), The University of Manchester; Faculty of Health, Psychology, and Social Care (R.M.), Manchester Metropolitan University; Department of Paediatric Anaesthesia (R.M.), Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK; Division of Emergency Medicine (T.C.), Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA; Division of Cardiac Critical Care (T.R.), Department of Pediatrics, Medical City Children's Hospital, Dallas, TX; NHS Harefield Trust (L.L.), Health Education England (HEE), London, UK; Division of Critical Care (N.T.), Children's Hospital Alabama, University of Alabama, Tuscaloosa, AL; Division of Emergency Medicine (K.F., A.S.), Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, St Louis University School of Medicine, St Louis, MO; Golden Valley Health Centers (C.G.), Modesto, CA; Department of Pediatrics and Emergency Medicine (C.G., M.A.), Yale University School of Medicine, New Haven, CT; Department of Research and Innovation (D.A.), Manchester University NHS Foundation Trust, Manchester, UK; Abigail Wexner Research Institute (M.M.-C.); and Division of Critical Care Medicine and Biostatistics Resource (M.M.-C.), Nationwide Children's Hospital, Columbus, OH.

出版信息

Simul Healthc. 2022 Apr 1;17(2):88-95. doi: 10.1097/SIH.0000000000000599.

DOI:10.1097/SIH.0000000000000599

PMID:34468421

Abstract

INTRODUCTION

Healthcare providers' anthropometric characteristics can adversely affect adult cardiopulmonary resuscitation (CPR) performance quality. However, their effects on infant CPR are unknown. We aimed to determine any relationships between healthcare provider characteristics (anthropomorphic, demographics, training, occupational data) and simulated infant CPR performance at multiple international sites. Our secondary aim was to examine provider's CPR performance degradation.

METHODS

Providers from 4 international hospitals performed 2 minutes of single-rescuer simulated infant CPR using 2015 American Heart Association Basic Life Support criteria with guidance from a real-time visual performance feedback device. Providers' characteristics were collected, and the simulator collected compression and ventilation data. Multivariate analyses examined the entire 2 minutes and performance degradation.

RESULTS

Data from 127 participants were analyzed. Although median values for all compression variables (depth, rate, lean) and ventilation volume were within guideline target ranges, when looking at individuals, only 52% chest compressions and 20% ventilations adhered to the American Heart Association guidelines. Age was found to be independently associated with ventilation volume (direct-relationship), and height was associated with chest compression lean (shorter participant-deeper lean). No significant differences were noted based on sex or body mass index. Neonatal intensive care unit participants were noted to perform shallower chest compressions (P < 0.001). Overall, there was minimal evidence of performance degradation over 2 minutes.

CONCLUSIONS

Isolated provider characteristics were noted among a diverse cohort of healthcare providers that may affect the CPR quality on a simulated infant. Understanding the relationships between provider characteristics and CPR quality could inform future infant CPR guidelines customized for the provider and not just the patient.

摘要

简介

医疗保健提供者的人体测量特征可能会对成人心肺复苏（CPR）的性能质量产生不利影响。然而，它们对婴儿 CPR 的影响尚不清楚。我们旨在确定多个国际地点的医疗保健提供者特征（人体测量学、人口统计学、培训、职业数据）与模拟婴儿 CPR 性能之间的任何关系。我们的次要目标是检查提供者的 CPR 性能下降。

方法

来自 4 家国际医院的提供者使用 2015 年美国心脏协会基本生命支持标准，在实时视觉绩效反馈设备的指导下，进行了 2 分钟的单人模拟婴儿 CPR。收集了提供者的特征，模拟器收集了压缩和通气数据。多变量分析检查了整个 2 分钟和性能下降。

结果

分析了 127 名参与者的数据。尽管所有压缩变量（深度、频率、倾斜）和通气量的中位数均在指南目标范围内，但从个体角度来看，只有 52%的胸外按压和 20%的通气符合美国心脏协会的指南。年龄被发现与通气量独立相关（直接关系），身高与胸外按压的倾斜度相关（参与者越矮，倾斜度越深）。性别或体重指数没有显著差异。新生儿重症监护病房的参与者的胸外按压深度较浅（P < 0.001）。总体而言，在 2 分钟内，性能下降的证据很少。