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心肺复苏中脉搏控制的新方法;连续股动脉脉搏检查。

A new method of pulse control in cardiopulmonary resuscitation; Continuous femoral pulse check.

机构信息

Kütahya Health Sciences University, Medical School, Department of Emergency Medicine, Kütahya, Turkey.

Bezmialem Vakif University Medical Faculty, Department of Emergency Medicine, İstanbul, Turkey.

出版信息

Am J Emerg Med. 2024 Jun;80:168-173. doi: 10.1016/j.ajem.2024.03.026. Epub 2024 Mar 31.

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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%。

结论

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。

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