将无人机技术纳入 OHCA 生存链：估计旁观者对 OHCA 的治疗和 CPR 表现所需的时间。
Incorporation of Drone Technology Into the Chain of Survival for OHCA: Estimation of Time Needed for Bystander Treatment of OHCA and CPR Performance.
机构信息
Department of Medicine, Duke University School of Medicine, Durham, NC (M.A.S.., D.B.M.).
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (M.A.S., C.L.G., D.B.M.).
出版信息
Circ Cardiovasc Qual Outcomes. 2024 Apr;17(4):e010061. doi: 10.1161/CIRCOUTCOMES.123.010061. Epub 2024 Mar 26.
BACKGROUND
Drone-delivered automated external defibrillators (AEDs) hold promises in the treatment of out-of-hospital cardiac arrest. Our objective was to estimate the time needed to perform resuscitation with a drone-delivered AED and to measure cardiopulmonary resuscitation (CPR) quality.
METHODS
Mock out-of-hospital cardiac arrest simulations that included a 9-1-1 call, CPR, and drone-delivered AED were conducted. Each simulation was timed and video-recorded. CPR performance metrics were recorded by a Laerdal Resusci Anne Quality Feedback System. Multivariable regression modeling examined factors associated with time from 9-1-1 call to AED shock and CPR quality metrics (compression rate, depth, recoil, and chest compression fraction). Comparisons were made among those with recent CPR training (≤2 years) versus no recent (>2 years) or prior CPR training.
RESULTS
We recruited 51 research participants between September 2019 and March 2020. The median age was 34 (Q1-Q3, 23-54) years, 56.9% were female, and 41.2% had recent CPR training. The median time from 9-1-1 call to initiation of CPR was 1:19 (Q1-Q3, 1:06-1:26) minutes. A median time of 1:59 (Q1-Q3, 01:50-02:20) minutes was needed to retrieve a drone-delivered AED and deliver a shock. The median CPR compression rate was 115 (Q1-Q3, 109-124) beats per minute, the correct compression depth percentage was 92% (Q1-Q3, 25-98), and the chest compression fraction was 46.7% (Q1-Q3, 39.9%-50.6%). Recent CPR training was not associated with CPR quality or time from 9-1-1 call to AED shock. Younger age (per 10-year increase; β, 9.97 [95% CI, 4.63-15.31] s; <0.001) and prior experience with AED (β, -30.0 [95% CI, -50.1 to -10.0] s; =0.004) were associated with more rapid time from 9-1-1 call to AED shock. Prior AED use (β, 6.71 [95% CI, 1.62-11.79]; =0.011) was associated with improved chest compression fraction percentage.
CONCLUSION
Research participants were able to rapidly retrieve an AED from a drone while largely maintaining CPR quality according to American Heart Association guidelines. Chest compression fraction was lower than expected.
背景
无人机配送的自动体外除颤器（AED）在治疗院外心脏骤停方面具有广阔的前景。我们的目标是评估使用无人机配送 AED 进行复苏所需的时间，并测量心肺复苏（CPR）质量。
方法
进行了模拟的院外心脏骤停急救，包括拨打 9-1-1 电话、CPR 和无人机配送 AED。每次模拟都进行了计时和视频记录。CPR 性能指标由 Laerdal Resusci Anne 质量反馈系统记录。多变量回归模型分析了与从 9-1-1 电话呼叫到 AED 电击之间的时间以及 CPR 质量指标（按压频率、深度、回弹和胸部按压分数）相关的因素。比较了最近（≤2 年）接受过 CPR 培训与无近期（>2 年）或之前接受过 CPR 培训的参与者。
结果
我们在 2019 年 9 月至 2020 年 3 月期间招募了 51 名研究参与者。中位年龄为 34 岁（四分位距 23-54 岁），56.9%为女性，41.2%有近期 CPR 培训。从 9-1-1 电话呼叫到开始 CPR 的中位时间为 1:19 分钟（四分位距 1:06-1:26 分钟）。需要 1:59 分钟（四分位距 01:50-02:20 分钟）的时间来取回无人机配送的 AED 并进行电击。中位 CPR 按压频率为 115 次/分钟（四分位距 109-124 次/分钟），正确按压深度百分比为 92%（四分位距 25-98%），胸部按压分数为 46.7%（四分位距 39.9%-50.6%）。最近的 CPR 培训与 CPR 质量或从 9-1-1 电话呼叫到 AED 电击之间的时间无关。年龄每增加 10 岁（β，9.97 [95%CI，4.63-15.31] s；<0.001）和之前有 AED 使用经验（β，-30.0 [95%CI，-50.1 至-10.0] s；=0.004）与从 9-1-1 电话呼叫到 AED 电击的时间更快相关。之前使用过 AED（β，6.71 [95%CI，1.62-11.79]；=0.011）与改善胸部按压分数百分比有关。
结论
研究参与者能够迅速从无人机上取回 AED，同时基本保持符合美国心脏协会指南的 CPR 质量。胸部按压分数低于预期。
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