ABSTRACT
Objective To investigate the efficacy of real-time visual feedback on improving the quality of manual chest compression in ambulance.Methods Ten pre-hospital doctors with cardiopulmonary resuscitation experience,aged under 40 years,were recruited to this randomized,crossover,manikin research and randomly assigned into control group (n=5) and feedback group (n=5) by the sealed envelope method.The setting place was a moving ambulance with the velocity of 25～50 km/ h.The whole process consisted of two sessions.In control group,which received feedback in the second session,chest compressions were performed without interruption during each of the three 2 min phases per session,resting for 2 min between phases and for 5 min between sessions.In feedback group,which received feedback in the first session,chest compressions were performed without interruption during each of the three 2 min phases per session,resting for 2 min between phases and for 5 min between sessions.Data of compression rate,compression depth,compression detention and compression accuracy rate were collected.Results In control group,the compressions rate was lower and compression detention was shorter during the second session compared with those during the first session [(109.8±±4.7) r/min vs.(121.2± 10.1) r/min,(6.5±2.1) r/min vs.(10.4±2.8) r/min,all P＜0.05],while the compression accuracy rate during the second session was higher than that during the first session [(28.2±±14.3) ％ vs.(16.8±9.9) ％,P＜0.05].There was no significant difference in compression rate between the two sessions in control group;Compression frequency,compression depth,compression detention and compression accuracy rate did not significantly change between the two sessions in feedback group (all P＞0.05).In the whole process,the compression rate was lower and compression detention was shorter in the feedback group compared with the control group [(111.1±5.1) r/min vs.(115.5±9.7) r/min,(6.5±1.8) vs.(8.4±4.6) r/min,all P＜0.05],and the compression accuracy rate in the feedback group was higher than that in the control group[(22.5±13.4) ％ vs.(26.7±16) ％,P＜0.05].There was no significant difference in compression rate between the two groups during whole process (P＞0.05).Conclusions Although real-time visual feed back improved the quality of manual chest compression in ambulances,which demonstrated more reasonable compression rate,less compression detention and higher compression accuracy,the overall quality of reuscitation was still not enough to achieve effective treatment.This implies that more optimal methods are required to transfer the patients suffering cardiac arrest.
ABSTRACT
Objective To explore the improvement of cardiopulmonary resuscitation (CPR) efficiency by rescue team through the clinical access to pre-hospital care.Methods Mter establishment of clinical approaches to cardiac arrest,the training program of first line personnel of rescue teams in the Hangzhou Emergency Center was carried out with practice on simulated patients and scenario.A total of 45 eligible teams were randomly enrolled for study by observing the performance of some essential resuscitation techniques before and after training.Result The efficiency of resuscitation performed by rescue team for cardiac arrest was generally not good enough before training evidenced by the shortage of application of ECG monitoring,endotracheal intubations and establishing intravenous line which were only 8 (17.8％),5(11.1％),6 (13.3 ％),respectively,and the interruption time of chest compression during the first three minutes was (102.13 ± 13.68) seconds and the successfully artificial respiration ratios by assistant members was (0.37 ± 0.09),and ratios of ECG forensics and written inform consent were 8 (17.8％) and 6 (13.3％) respectively,CPR and forensics done simultaneously was only 2 (4.4％).The efficiency of rescue for cardiac arrest was obviously improved after training by the clinical approaches proved by the increase in application of ECG monitoring,endotracheal intubations,intravenous line set up reached to 45 (100％),43 (95.6％),43 (95.6％),respectively,and the interruption time of chest compression during the first three minutes was shorten to (69.7 ± 7.7) seconds and the successfully artificial respiration ratios done by assistant members was (0.57 ±0.12) after training.The ratios of on-site ECG forensics and written inform consent were 40 (88.9％) and 43 (95.6％),respectively,and CPR and evidence obtained simultaneously was up to 36 (80.0％).The efficiency of work done by teams was obviously improved and the risk of miserable events was controlled.Conclusions The clinical approaches to cardiac arrest in prehosptial care is the efficient strategy to rescue the patient with cardiac arrest and it is worthy to popularize at present.