Lin Shih-Jhan, Chang Chih-Jan, Chu Shao-Chung, Chang Ying-Hsin, Hong Ming-Yuan, Huang Po-Chang, Kao Chia-Lung, Chi Chih-Hsien
Department of Emergency Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No.138, Sheng Li Road, Tainan city, 704, Taiwan.
Taiwan Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
BMC Emerg Med. 2025 Jan 29;25(1):19. doi: 10.1186/s12873-024-01162-z.
Out-of-hospital cardiac arrest (OHCA) presents significant challenges with low survival rates, emphasizing the need for effective bystander CPR training. In Basic Life Support (BLS) training, the role of instructors is pivotal as they assess and correct learners' cardiopulmonary resuscitation (CPR) techniques to ensure proficiency in life-saving skills. This study evaluates the concordance between CPR quality assessments by Basic Life Support (BLS) instructors and those determined through Quantitative CPR (QCPR) devices, utilizing data from BLS courses conducted at National Cheng Kung University Hospital from October 2017 to April 2018.
The study analyzed existing data from BLS courses, comparing CPR quality assessments made by instructors with those recorded by QCPR devices. Key metrics such as chest compression speed, depth, and recoil were examined to identify the degree of consistency between human and automated evaluations.
In this study, CPR performance was analyzed using QCPR devices and BLS instructors across metrics like speed, depth, and recoil. Employing the Cohen kappa statistic revealed moderate to low interrater reliability, the kappa value is 0.65 (95% C.I. 0.65-0.65) for depth, 0.56 (95% C.I. 0.33-0.79) for speed, and 0.50 (95% C.I.0.28-0.71) for recoil. Correlation analysis visualized in a heatmap indicated a higher consistency in depth evaluations (correlation coefficient = 0.7) compared to speed and recoil, suggesting a need for improved alignment in CPR training assessments.
The study underscores the importance of refining CPR training methods and adopting advanced technological aids to enhance the reliability of CPR skill assessments. By improving the accuracy of these evaluations, the training can be better tailored to increase the effectiveness of life-saving interventions, potentially boosting survival rates in out-of-hospital cardiac arrest scenarios.
院外心脏骤停（OHCA）带来了重大挑战，生存率较低，这凸显了进行有效的旁观者心肺复苏术（CPR）培训的必要性。在基础生命支持（BLS）培训中，教员的作用至关重要，因为他们要评估并纠正学习者的心肺复苏技术，以确保其掌握救生技能。本研究利用国立成功大学医院2017年10月至2018年4月开展的BLS课程数据，评估基础生命支持（BLS）教员对心肺复苏质量的评估与通过定量心肺复苏（QCPR）设备确定的评估之间的一致性。
该研究分析了BLS课程的现有数据，将教员进行的心肺复苏质量评估与QCPR设备记录的评估进行比较。对胸外按压速度、深度和回弹等关键指标进行了检查，以确定人工评估与自动评估之间的一致程度.
在本研究中，使用QCPR设备和BLS教员对心肺复苏表现进行了速度、深度和回弹等指标方面的分析。采用科恩kappa统计量显示评分者间信度为中度至低度，深度的kappa值为0.65（95%置信区间0.65 - 0.65）、速度为0.56（95%置信区间0.33 - 0.79）、回弹为0.50（95%置信区间0.28 - 0.71）。热图中的相关性分析表明深度评估的一致性更高（相关系数 = 0.7），高于速度和回弹评估，这表明心肺复苏培训评估需要更好地保持一致。
该研究强调了改进心肺复苏培训方法和采用先进技术辅助手段以提高心肺复苏技能评估可靠性的重要性。通过提高这些评估的准确性，培训可以更好地量身定制，以提高救生干预措施的有效性，有可能提高院外心脏骤停情况下的生存率。
