Kao Chia-Lung, Tsou Jui-Yi, Hong Ming-Yuan, Chang Chih-Jan, Su Fong-Chin, Chi Chih-Hsien
Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.
Heliyon. 2022 Oct 8;8(10):e10990. doi: 10.1016/j.heliyon.2022.e10990. eCollection 2022 Oct.
Human thoracic stiffness varies and may affect the performance during external chest compression (ECC). The Extra Compression Spring Resusci® QCPR Anne manikin is a high-fidelity training model developed for ECC training that can account for varying levels of thoracic stiffness. The aim of this study was to use this training model to investigate the effects of thoracic stiffness on ECC biomechanics and qualities.
Fifty-two participants performed standard ECC on the manikin with different thoracic springs to simulate varying levels of thoracic stiffness. The MatScan Pressure Measurement system was used to investigate the ECC pressure and force distribution.
The hard spring group's performance had a better complete recoil ratio (90.06 ± 24.84% vs. 79.75 ± 32.17% vs. 56.42 ± 40.15%, < 0.001 at second minute), but was more inferior than the standard and soft spring groups in overall quality, ECC depth (34.17 ± 11.45 mm vs. 41.25 ± 11.42 mm vs. 51.88 ± 7.56, < 0.001 at second minutes), corrected depth ratio, and corrected rate ratio. The hard spring group had less radial-ulnar peak pressure difference (kgf/cm) than the other two groups (-0.28 ± 0.38 vs. -0.30 ± 0.43 vs. -0.47 ± 0.34, = 0.01), demonstrating that more symmetrical pressure was applied in the hard spring group. The soft spring group had better ECC depth, corrected depth ratio, corrected rate ratio, and overall quality, but its performance in complete recoil was inferior, and unbalanced pressure was more liable to cause injury. Hard springs caused operator fatigue easily.
The thoracic stiffness greatly affected the performance of ECC. Our findings provided information for more effective ECC practices and training.
人体胸廓硬度存在差异，可能会影响胸外按压（ECC）期间的操作表现。Extra Compression Spring Resusci® QCPR安妮人体模型是一种为ECC训练开发的高保真训练模型，能够模拟不同程度的胸廓硬度。本研究旨在使用该训练模型来探究胸廓硬度对ECC生物力学及质量的影响。
52名参与者使用不同的胸廓弹簧在人体模型上进行标准ECC操作，以模拟不同程度的胸廓硬度。使用MatScan压力测量系统来研究ECC压力及力的分布情况。
硬弹簧组在第二次按压时的完全回弹率表现更佳（90.06±24.84% vs. 79.75±32.17% vs. 56.42±40.15%，P<0.001），但在整体质量、ECC深度（第二次按压时34.17±11.45毫米 vs. 41.25±11.42毫米 vs. 51.88±7.56，P<0.001）、校正深度比及校正速率比方面比标准弹簧组和软弹簧组差。硬弹簧组的桡尺峰值压力差（kgf/cm）比其他两组小（-0.28±0.38 vs. -0.30±0.43 vs. -0.47±0.34，P=0.01），表明硬弹簧组施加的压力更对称。软弹簧组的ECC深度、校正深度比、校正速率比及整体质量更佳，但其完全回弹表现较差，且压力不均衡更容易导致损伤。硬弹簧容易导致操作者疲劳。
胸廓硬度对ECC操作表现有很大影响。我们的研究结果为更有效的ECC实践和训练提供了信息。
