Chen Liang, Shen Yang, Liu Shuangmei, Cao Yanyan, Zhu Zhe
Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
Prehosp Emerg Care. 2023;27(6):713-717. doi: 10.1080/10903127.2022.2095066. Epub 2022 Jul 14.
To evaluate the effect of wearing an N95 mask on the quality of chest compression and fatigue of prehospital emergency personnel during cardiopulmonary resuscitation (CPR).
Twenty-four eligible participants were recruited. Participants' age, sex, height, and weight were recorded. After completing the CPR training and examination, participants were tested twice, wearing surgical mask or an N95 mask, while performing chest compressions for 2 minutes. The quality of chest compression (including compression frequency, depth, rebound, and position) was recorded by the simulator. Borg fatigue scores and physiological parameters (including heart rate, mean arterial pressure, pulse oxygen saturation, and respiratory rate) were recorded before and after chest compressions.
Compared to wearing surgical masks, participants wearing N95 masks had significantly lower quality of chest compression, including compression frequency (98.3 ± 4.9 bpm vs 104.0 ± 6.0 bpm, P < 0.001), depth (47.1 ± 4.5 mm vs 50.5 ± 5.4 mm, P < 0.001), and rebound (90.2 ± 2.7% vs 94.3 ± 2.1%, P < 0.001). The compression position was not affected. The period data showed that the difference in compression quality started after 1 minute of compressions. Participants wearing N95 masks had higher Borg fatigue scores [6.1(2) vs 5.1(2), P < 0.001], heart rates (121.2 ± 5.7 bpm vs 109.9 ± 6.0 bpm, P < 0.001), mean arterial pressures (106.3 ± 8.0 mmHg vs 99.0 ± 8.5 mmHg, P = 0.012), and respiratory rates (29.5 ± 2.7 bpm vs 24.7 ± 2.5 bpm, P < 0.001).
This study showed that the use of an N95 mask by prehospital emergency personnel during the performance of chest compressions resulted in a reduction of compression quality and increased clinician fatigue. There is a need for CPR training for medical personnel wearing personal protective equipment.
评估佩戴N95口罩对院前急救人员在心肺复苏（CPR）过程中胸外按压质量及疲劳程度的影响。
招募24名符合条件的参与者。记录参与者的年龄、性别、身高和体重。在完成CPR培训和考核后，参与者分别佩戴外科口罩或N95口罩进行两次测试，每次进行2分钟的胸外按压。由模拟器记录胸外按压质量（包括按压频率、深度、回弹和位置）。记录胸外按压前后的Borg疲劳评分及生理参数（包括心率、平均动脉压、脉搏血氧饱和度和呼吸频率）。
与佩戴外科口罩相比，佩戴N95口罩的参与者胸外按压质量显著降低，包括按压频率（98.3±4.9次/分钟 vs 104.0±6.0次/分钟，P<0.001）、深度（47.1±4.5毫米 vs 50.5±5.4毫米，P<0.001）和回弹（90.2±2.7% vs 94.3±2.1%，P<0.001）。按压位置未受影响。时段数据显示，按压1分钟后按压质量出现差异。佩戴N95口罩的参与者Borg疲劳评分更高[6.1(2) vs 5.1(2)，P<0.001]，心率更高（121.2±5.7次/分钟 vs 109.9±6.0次/分钟，P<0.001），平均动脉压更高（106.3±8.0毫米汞柱 vs 99.0±8.5毫米汞柱，P=0.012），呼吸频率更高（29.5±2.7次/分钟 vs 24.7±2.5次/分钟，P<0.001）。
本研究表明，院前急救人员在进行胸外按压时佩戴N95口罩会导致按压质量下降，并增加临床医生的疲劳程度。对佩戴个人防护装备的医务人员进行CPR培训很有必要。
