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除颤电击时未使用个人防护装备的普通公众电击风险评估:一项模拟研究。

Risk assessment of electric shock to the general public without Personal Protective Equipment during defibrillation shock delivery: A simulation study.

作者信息

Kurosaki Hisanori, Ninomiya Shinji, Sasaki Koichi, Yasuda Yasuharu

机构信息

Department of Emergency Medical Science, Faculty of Health Sciences, Kyoto Tachibana University, 34 Yamada-cho Oyake, Yamashina-ku, Kyoto 607-8175, Japan.

Department of Medical Science and Technology, Faculty of Health Sciences, Hiroshima International University, 555-36 Kurose-gakuendai, Higashi-hiroshima, Hiroshima 739-2695, Japan.

出版信息

Resusc Plus. 2024 Jul 31;19:100734. doi: 10.1016/j.resplu.2024.100734. eCollection 2024 Sep.

Abstract

AIM

This study aimed to elucidate the risk of electric shock when the general public, not wearing Personal Protective Equipment (PPE), is in contact with a patient, and a defibrillation shock is inadvertently delivered.

METHODS

A simulation study was conducted simulating the following scenarios. 1) Both the rescuer and the patient were isolated from the ground, with the rescuer making single-point contact with the patient. 2) Both the rescuer and the patient were in contact with the common ground, and the rescuer made single-point contact with the patient. 3) The rescuer made contact at two different points to the patient. A mannequin with a towel saturated with 3% saline solution placed on the chest was used. Defibrillation shocks were delivered using a defibrillator three times at each of three energies: 150 J, 200 J, and 360 J. The voltage across the simulated rescuer was measured with an oscilloscope.

RESULTS

In Scenario 1, all measurements were below the detection limit. In Scenario 2, the voltage and current across the rescuer increased with higher defibrillation shock energy, averaging 156.8 V and 156.8 mA at 360 J. In Scenario 3, voltage peaked at 326.0 V and current at 326.0 mA at 360 J.

CONCLUSION

In a simulated setting of defibrillation, over 300 mA of current could pass through the rescuer without PPE when having two contact points between the manikin and the rescuer. However, due to the brief duration and low energy, immediate danger to the rescuer is considered low.

摘要

目的

本研究旨在阐明普通公众在未穿戴个人防护装备(PPE)的情况下接触患者且意外发生除颤电击时触电的风险。

方法

进行了一项模拟研究,模拟以下场景。1)救援人员和患者均与地面隔离,救援人员与患者单点接触。2)救援人员和患者均与公共地面接触,救援人员与患者单点接触。3)救援人员与患者在两个不同点接触。使用一个胸部放置有浸满3%盐溶液毛巾的人体模型。使用除颤器在三种能量水平(150 J、200 J和360 J)下各进行三次除颤电击。用示波器测量模拟救援人员身上的电压。

结果

在场景1中,所有测量值均低于检测限。在场景2中,救援人员身上的电压和电流随着除颤电击能量的增加而升高,在360 J时平均为156.8 V和156.8 mA。在场景3中,在360 J时电压峰值为326.0 V,电流峰值为326.0 mA。

结论

在模拟除颤环境中,当人体模型与救援人员之间有两个接触点时,未穿戴PPE的救援人员身上可能会有超过300 mA的电流通过。然而,由于持续时间短且能量低,对救援人员的直接危险被认为较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1091/11345396/fea895d41096/gr1.jpg

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