Kütahya Health Sciences University, Medical School, Department of Emergency Medicine, Kütahya, Turkey.
Bezmialem Vakif University Medical Faculty, Department of Emergency Medicine, İstanbul, Turkey.
Am J Emerg Med. 2024 Jun;80:168-173. doi: 10.1016/j.ajem.2024.03.026. Epub 2024 Mar 31.
The reliability of manual pulse checks has been questioned but is still recommended in cardiopulmonary resuscitation (CPR) guidelines. The aim is to compare the 10-s carotid pulse check (CPC) between heart massage cycles with the continuous femoral pulse check (CoFe PuC) in CPR, and to propose a better location to shorten the interruption times for pulse check.
A prospective study was conducted on 117 Non-traumatic CPR patients between January 2020 and January 2022. A total of 702 dependent pulse measurements were executed, where carotid and femoral pulses were simultaneously assessed. Cardiac ultrasound, end-tidal CO2, saturation, respiration, and blood pressure were employed for pulse validation.
The decision time for determining the presence of a pulse in the last cycle of CPR was 3.03 ± 1.26 s for CoFe PuC, significantly shorter than the 10.31 ± 5.24 s for CPC. CoFe PuC predicted the absence of pulse with 74% sensitivity and 88% specificity, while CPC predicted the absence of pulse with 91% sensitivity and 61% specificity.
CoFe PuC provides much earlier and more effective information about the pulse than CPC. This shortens the interruption times in CPR. CoFe PuC should be recommended as a new and useful method in CPR guidelines.
手动脉搏检查的可靠性一直受到质疑,但仍被心肺复苏 (CPR) 指南推荐。目的是比较 CPR 中心脏按摩周期中的 10 秒颈动脉脉搏检查 (CPC) 与连续股动脉脉搏检查 (CoFe PuC),并提出一个更好的位置来缩短脉搏检查的中断时间。
对 2020 年 1 月至 2022 年 1 月期间的 117 例非创伤性 CPR 患者进行了前瞻性研究。共进行了 702 次依赖脉搏测量,同时评估颈动脉和股动脉脉搏。心脏超声、呼气末 CO2、饱和度、呼吸和血压用于脉搏验证。
在 CPR 最后一个周期确定脉搏存在的决策时间,CoFe PuC 为 3.03±1.26 s,明显短于 CPC 的 10.31±5.24 s。CoFe PuC 预测无脉搏的灵敏度为 74%,特异性为 88%,而 CPC 预测无脉搏的灵敏度为 91%,特异性为 61%。
CoFe PuC 比 CPC 更早、更有效地提供脉搏信息。这缩短了 CPR 中的中断时间。CoFe PuC 应作为 CPR 指南中的一种新的有用方法推荐。