The effect of Pit-Crew cardiopulmonary resuscitation on the quality of chest compression / 中华急诊医学杂志

ABSTRACT

Objective:To observe the effect of team resuscitation with Pit-Crew cardiopulmonary resuscitation (CPR) mode on improving the quality of chest compression.Methods:A control method was conducted in this study. Sixty-four medical staffs in ICU and Emergency departments were divided into the role division group and non-role division group according to the ratio of doctors to nurses, with 8 teams in each group and 4 staffs in each team. A team leader was appointed in each team of the role division group to organize and coordinate the whole CPR process, and the non-role division group was not appointed. Each team performed chest compression for 8 min according to the recommendations of the 2020 AHA CPR Guideline under the monitoring of the CPR quality tracking system using a resuscitation manikin. CPR time, chest compression fraction (CCF), times of pressing interruption, times of pressing exceeding standard interruption (>10 s), pressing frequency, chest full recoil rate and other parameters were observed and recorded. The computer system recorded the above parameters, Student's t test and Mann-Whitney U test were used to compare the differences of indexes between the two groups. Results:After the training, the role division group achieved higher CCF [(69.13±1.55)% vs. (59.13 ± 6.08)%, P<0.05], and the total time was significantly shorter and times of overshoot interruptions was significantly less in the role division group compared with the non-role division group [(79.88±28.76) s vs. (135.25±32.99) s; 4 (3, 5) times vs. 2 (1, 2) times respectively; P<0.01]. There were no statistical differences in the total time of CPR and interruption numbers ( P>0.05). In addition, there were also no statistically significant differences in the pressing total numbers, correct times, pressing frequency, pressing depth, and the full rebound times of compression, as well as the substandard indicators of compression such as pressing too fast, too slow, too deep and insufficient rebound times of compression (all P>0.05). Conclusions:Pit-Crew CPR mode with designated team leader contributes to the implementation of high quality CPR, and the monitoring of CPR quality parameters and the applying of real-time feedback system can effectively improve the quality of chest compression.