Gehlen Marcel, Brokmann Jörg Christian, Röhrig Rainer, Hübel Christian, Unterkofler Jenny, Plata Christopher
Department for Acute and Emergency Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
Institute for Medical Informatics, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
Am J Emerg Med. 2025 Mar;89:12-18. doi: 10.1016/j.ajem.2024.11.091. Epub 2024 Dec 7.
High quality chest compressions are essential for survival and good neurological outcome in out-of-hospital cardiac arrest (OHCA). Dispatcher- assisted CPR (DA-CPR) has led to increased survival in OHCA. Recently, additional verbal motivation has shown positive effects on CPR quality. The present randomized and controlled simulation trial investigates the effect of different intervals of verbal motivation during DA-CPR.
159 medical laypersons performed eight minutes of CPR on a simulator after randomization into one of three study groups: 1) "DA-CPR" 2) "DA-CPR + motivation every 30s" 3) "DA-CPR + motivation every 60s". Verbal motivation consisted of "push harder, do not relent. Additionally, a metronome beat was audible via telephone in the motivation groups. Primary endpoint was the difference in median chest compression depth during the eight-minute CPR compared between the study groups.
There were significant differences in median compression depth between the three study groups (p = 0.002). However, only the group "DA-CPR + motivation every 60s" showed a significant difference in compression depth compared to standard DA-CPR and was within the recommended range. Compressions with adequate depth (p = 0.009) and median compression rate (p < 0.001) were significantly elevated in both motivational groups compared to the "DA-CPR"-group.
Verbal encouragement every 30 or 60 s combined with a metronome beat led to a significant augmentation of chest compression depth compared to standard DA-CPR.
高质量的胸外按压对于院外心脏骤停（OHCA）患者的生存及良好的神经功能预后至关重要。调度员辅助心肺复苏（DA-CPR）已提高了OHCA患者的生存率。最近，额外的言语激励已显示出对心肺复苏质量有积极影响。本随机对照模拟试验研究了DA-CPR期间不同间隔的言语激励的效果。
159名非专业医护人员在被随机分为三个研究组之一后，在模拟器上进行8分钟的心肺复苏：1）“DA-CPR”组；2）“DA-CPR + 每30秒给予激励”组；3）“DA-CPR + 每60秒给予激励”组。言语激励内容为“用力按压，不要松懈”。此外，在激励组中可通过电话听到节拍器的节拍。主要终点是比较各研究组在8分钟心肺复苏期间胸外按压深度中位数的差异。
三个研究组之间的按压深度中位数存在显著差异（p = 0.002）。然而，只有“DA-CPR + 每60秒给予激励”组与标准DA-CPR组相比，在按压深度上有显著差异，且处于推荐范围内。与“DA-CPR”组相比，两个激励组中具有足够深度的按压（p = 0.009）和按压深度中位数（p < 0.001）均显著增加。
与标准DA-CPR相比，每30或60秒的言语鼓励结合节拍器节拍可显著增加胸外按压深度。
