Ochoa F J, Ramalle-Gómara E, Carpintero J M, García A, Saralegui I
Intensive Care Unit, San Millán Hospital, La Rioja, Spain.
Resuscitation. 1998 Jun;37(3):173-5. doi: 10.1016/s0300-9572(98)00055-0.
Our objective was to establish the proportion of Emergency Room and Intensive Care doctors and nurses able to locate the carotid pulse in less than 5 s, and identify the variables that influence this ability. The method followed was locating the carotid pulse in a healthy male adult volunteer with normal blood pressure in two situations (stretcher or floor) and with the neck in either a neutral or in an extended position. We recorded the gender, age, and previous training in cardiopulmonary resuscitation (CPR) of each participant and the time spent in detecting the pulse in each of the four possible positions. A model of logistic regression was constructed to determine if the patient's position had any influence on the proportion of health workers capable of finding the pulse within 5 s. The average age of the 72 subjects studied was 33.4 years (SD = 6.6); 80% of the participants had CPR training. Thirty-one participants (43.1%; CI 95%, 31.4-55.3%) required more than 5 s to detect the pulse, although only three (4.2%; CI 95%, 0.9-11.7%) required more than 10 s. The variable 'no CPR training' was associated with the inability to detect the pulse within 5 s. The detection of the pulse was easier with an extended neck. A significant proportion of nurses and doctors were slow to locate the carotid pulse on a healthy, young volunteer with normal blood pressure. No relation was found between gender or age of the participants. More attention should be given to carotid pulse detection in CPR training.
我们的目标是确定能够在5秒内找到颈动脉搏动的急诊室和重症监护医生及护士的比例,并识别影响这一能力的变量。采用的方法是在两种情况下(担架上或地面上),让一名血压正常的健康成年男性志愿者的颈部处于中立或伸展位置,来寻找颈动脉搏动。我们记录了每位参与者的性别、年龄、之前的心肺复苏(CPR)培训情况以及在四种可能位置中每种位置检测脉搏所花费的时间。构建了一个逻辑回归模型,以确定患者的位置是否对能够在5秒内找到脉搏的医护人员比例有任何影响。研究的72名受试者的平均年龄为33.4岁(标准差 = 6.6);80%的参与者接受过CPR培训。31名参与者(43.1%;95%置信区间,31.4 - 55.3%)检测脉搏需要超过5秒,尽管只有3名(4.2%;95%置信区间,0.9 - 11.7%)需要超过10秒。“未接受CPR培训”这一变量与无法在5秒内检测到脉搏相关。颈部伸展时更容易检测到脉搏。相当一部分护士和医生在寻找一名血压正常的健康年轻志愿者的颈动脉搏动时动作迟缓。未发现参与者的性别或年龄之间存在关联。在CPR培训中应更加关注颈动脉搏动的检测。