Department of Emergency Medicine, UC Davis, Sacramento, CaliforniaUSA.
Department of Pediatrics, UC Davis, Sacramento, CaliforniaUSA.
Prehosp Disaster Med. 2022 Oct;37(5):630-637. doi: 10.1017/S1049023X22001042. Epub 2022 Jul 25.
Studies have demonstrated the efficacy of mechanical devices at delivering high-quality cardiopulmonary resuscitation (HQ-CPR) in various transport settings. Herein, this study investigates the efficacy of manual and mechanical HQ-CPR delivery on a fire rescue boat.
A total of 15 active firefighter-paramedics were recruited for a prospective manikin-based trial. Each paramedic performed two minutes manual compression-only CPR while navigating on a river-based fire rescue boat. The boat was piloted in either a stable linear manner or dynamic S-turn manner to simulate obstacle avoidance. For each session of manual HQ-CPR, a session of mechanical HQ-CPR was also performed with a LUCAS 3 (Stryker; Kalamazoo, Michigan USA). A total of 60 sessions were completed. Parameters recorded included compression fraction (CF) and the percentage of compressions with correct depth >5cm (D%), correct rate 100-120 (R%), full release (FR%), and correct hand position (HP%). A composite HQ-CPR score was calculated as follows: ((D% + R% + FR% + HP%)/4) * CF%). Differences in magnitude of change seen in stable versus dynamic navigation within study conditions were evaluated with a Z-score calculation. Difficulty of HQ-CPR delivery was assessed utilizing the Borg Rating of Perceived Exertion Scale.
Participants were mostly male and had a median experience of 20 years. Manual HQ-CPR delivered during stable navigation out-performed manual HQ-CPR delivered during dynamic navigation for composite score and trended towards superiority for FR% and R%. There was no difference seen for any measured variable when comparing mechanical HQ-CPR delivered during stable navigation versus dynamic navigation. Mechanical HQ-CPR out-performed manual HQ-CPR during both stable and dynamic navigation in terms of composite score, FR%, and R%. Z-score calculation demonstrated that manual HQ-CPR delivery was significantly more affected by drive style than mechanical HQ-CPR delivery in terms of composite HQ-CPR score and trended towards significance for FR% and R%. Borg Rating of Perceived Exertion was higher for manual CPR delivered during dynamic sessions than for stable sessions.
Mechanical HQ-CPR delivery is superior to manual HQ-CPR delivery during both stable and dynamic riverine navigation. Whereas manual HQ-CPR delivery was worse during dynamic transportation conditions compared to stable transport conditions, mechanical HQ-CPR delivery was unaffected by drive style. This suggests the utility of routine use of mechanical HQ-CPR devices in the riverine patient transport setting.
多项研究表明，在各种转运环境下，机械装置在提供高质量心肺复苏（HQ-CPR）方面是有效的。在此，本研究调查了在消防救援船上手动和机械 HQ-CPR 输送的效果。
共招募了 15 名现役消防护理人员进行基于模拟人的前瞻性试验。每位护理人员在一条基于河流的消防救援船上进行两分钟的手动仅按压 CPR。船只以稳定的直线方式或动态 S 形转弯方式行驶，以模拟障碍物避让。对于每轮手动 HQ-CPR，还使用 LUCAS 3（Stryker；密歇根州卡拉马祖）进行一轮机械 HQ-CPR。共完成了 60 轮。记录的参数包括压缩分数（CF）和正确按压深度>5cm 的百分比（D%）、正确率 100-120（R%）、完全释放（FR%）和正确手位（HP%）。计算了综合 HQ-CPR 评分如下：（（D%+R%+FR%+HP%）/4）*CF%）。使用 Z 分数计算评估了在研究条件下稳定与动态导航之间观察到的变化幅度的差异。使用 Borg 感知用力量表评估 HQ-CPR 输送的难度。
参与者主要为男性，中位经验为 20 年。与动态导航相比，在稳定导航期间进行的手动 HQ-CPR 在复合评分方面优于手动 HQ-CPR，并且在 FR%和 R%方面具有优势。比较稳定导航和动态导航期间的机械 HQ-CPR 输送，在任何测量变量方面均无差异。在稳定和动态导航方面，机械 HQ-CPR 在复合评分、FR%和 R%方面均优于手动 HQ-CPR。Z 分数计算表明，在 HQ-CPR 综合评分方面，手动 HQ-CPR 输送受驱动方式的影响明显大于机械 HQ-CPR 输送，并且在 FR%和 R%方面也有趋势。在动态会话中进行手动 CPR 时，Borg 感知用力量表的评分高于在稳定会话中进行手动 CPR 时的评分。
在稳定和动态河流导航期间，机械 HQ-CPR 输送优于手动 HQ-CPR 输送。与稳定转运条件相比，手动 HQ-CPR 输送在动态转运条件下较差，而机械 HQ-CPR 输送不受驱动方式的影响。这表明在河流患者转运环境中常规使用机械 HQ-CPR 设备是有用的。
