School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
Front Public Health. 2022 Jul 7;10:895367. doi: 10.3389/fpubh.2022.895367. eCollection 2022.
To design an innovative team-based cardiopulmonary resuscitation (CPR) educational plan for multiple bystanders and evaluate whether it was associated with better teamwork and higher quality of resuscitation.
The team-based CPR plan defined the process for a three-person team, emphasize task allocation, leadership, and closed-loop communication. Participants qualified for single-rescuer CPR skills were randomized into teams of 3. The teamwork performance and CPR operation skills were evaluated in one simulated cardiac arrest scenario before and after training on the team-based CPR plan. The primary outcomes were measured by the Team Emergency Assessment Measure (TEAM) scale and chest compression fraction (CCF).
Forty-three teams were included in the analysis. The team-based CPR plan significantly improved the team performance (global rating 6.7 ± 1.3 vs. 9.0 ± 0.7, corrected < 0.001 after Bonferroni's correction). After implementing the team-based CPR plan, CCF increased [median 59 (IQR 48-69) vs. 64 (IQR 57-71%)%, corrected = 0.002], while hands-off time decreased [median 233.2 (IQR 181.0-264.0) vs. 207 (IQR 174-222.9) s, corrected = 0.02]. We found the average compression depth was significantly improved through the team-based CPR training [median 5.1 (IQR 4.7-5.6) vs. 5.3 (IQR 4.9-5.5) cm, = 0.03] but no more significantly after applying the Bonferroni's correction (corrected = 0.35). The compression depths were significantly improved by collaborating and exchanging the role of compression among the participants after the 6th min.
The team-based CPR plan is feasible for improving bystanders teamwork performance and effective for improving resuscitation quality in prearrival care. We suggest a wide application of the team-based CPR plan in the educational program for better resuscitation performance in real rescue events.
设计一种创新的多人基础心肺复苏（CPR）教育计划，并评估其是否与更好的团队合作和更高质量的复苏相关。
该基于团队的 CPR 计划定义了三人团队的流程，强调任务分配、领导力和闭环沟通。符合单人 CPR 技能条件的参与者被随机分为三人一组。在基于团队的 CPR 计划培训前后，在一个模拟心搏骤停场景中评估团队协作表现和 CPR 操作技能。主要结局指标通过团队紧急评估量表（TEAM）和胸外按压分数（CCF）进行测量。
共有 43 个团队纳入分析。基于团队的 CPR 计划显著提高了团队表现（总体评分 6.7 ± 1.3 对 9.0 ± 0.7，经 Bonferroni 校正后 < 0.001）。实施基于团队的 CPR 计划后，CCF 增加[中位数 59（IQR 48-69）对 64（IQR 57-71）%，经校正后 = 0.002]，而脱手时间减少[中位数 233.2（IQR 181.0-264.0）对 207（IQR 174-222.9）s，经校正后 = 0.02]。我们发现，通过基于团队的 CPR 培训，平均按压深度显著提高[中位数 5.1（IQR 4.7-5.6）对 5.3（IQR 4.9-5.5）cm， = 0.03]，但经 Bonferroni 校正后不再更显著（校正后 = 0.35）。在第 6 分钟后，参与者通过协作和相互交换按压角色，按压深度显著提高。
基于团队的 CPR 计划对于提高旁观者的团队协作表现是可行的，并且对于改善院前急救的复苏质量是有效的。我们建议广泛应用基于团队的 CPR 计划，以在实际救援事件中提高复苏表现。
