Journal of The Korean Society of Emergency Medicine (대한응급의학회지)

The Korean Society of Emergency Medicine (대한응급의학회)
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Analysis of the Time-Dependent Changes of Chest Compression Quality and Related Rescuer Factors in Cardio-Pulmonary Resuscitation by Lay-Persons

일반인의 심폐소생술 시 시간의 흐름에 따른 구조자의 피로에 의한 가슴압박의 질 변화와 이와 관련된 구조자의 특성; 마네킹을 이용한 가상 연구

  • Na, Joon-Ho (Department of Emergency Medicine, Konkuk University School of Medicine) ;
  • Park, Sang-O (Department of Emergency Medicine, Konkuk University School of Medicine) ;
  • Baek, Kwang-Je (Department of Emergency Medicine, Konkuk University School of Medicine) ;
  • Hong, Dae-Young (Department of Emergency Medicine, Konkuk University School of Medicine) ;
  • Lee, Kyeong-Ryong (Department of Emergency Medicine, Konkuk University School of Medicine) ;
  • Lee, Myung-Hyun (CPR Education Center, Konkuk University Medical Center)
  • 나준호 (건국대학교 의과대학 응급의학교실) ;
  • 박상오 (건국대학교 의과대학 응급의학교실) ;
  • 백광제 (건국대학교 의과대학 응급의학교실) ;
  • 홍대영 (건국대학교 의과대학 응급의학교실) ;
  • 이경룡 (건국대학교 의과대학 응급의학교실) ;
  • 이명현 (건국대학교병원 심폐소생술 교육센터)
  • Published : 2011.10.30
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Abstract

Purpose: The study evaluated changes in the quality of chest compressions over 2 min in 30:2 cardio-pulmonary resuscitation (CPR) by lay-persons and analyzed rescuer factors affecting the quality of chest compressions over time. Methods: CPR training courses attended by 538 adult hospital and university workers (lay-person) were conducted at a university hospital. After 4-hour CPR training, tests were performed using a manikin with Skill-$Reporter^{TM}$. Data of 459 subjects were analyzed concerning the quality of chest compressions over time and rescuer factors such as age, gender, body mass index, prior CPR training and CPR experience were also analyzed to determine their effect on the change in the quality of chest compressions. Results: Compression depth (p=0.002) showed significant change over 2 min, but the rate (p=0.133), chest recoil (p=0.442) and hand placement (p=0.991) were insignificant. Ineffective compression depth (mean proportions of correct depth<70%) was not observed during the 2 min CPR. Female gender (p<0.001; OR, 5.882, 95% CI, 3.098-11.167) and no CPR training (p=0.004; OR, 2.163, 95% CI, 1.277-3.663) were associated with decline of compression depth. Time-dependent analysis revealed significant ineffective compression depth (<70%) in females and underweight patients (p<0.001). Conclusion: Switching compressors at an interval of 2 min is reasonable for 30:2 CPR by lay-persons. But, significant decline of correct compression depth over time in female and underweight rescuers was evident.

Keywords

References

  1. International Liaison Committee on Resuscitation. 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Part 2: Adult basic life support. Resuscitation 2005 Nov-Dec;67:187-201. https://doi.org/10.1016/j.resuscitation.2005.09.016
  2. Berg RA, Hemphill R, Abella BS, Aufderheide TP, Cave DM, Hazinski MF, et al. Part 5: adult basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122(18 Suppl 3):S685-705.
  3. Hightower D, Thomas SH, Stone CK, Dunn K, March JA. Decay in quality of closed-chest compressions over time. Ann Emerg Med 1995;26:300-3. https://doi.org/10.1016/S0196-0644(95)70076-5
  4. Ochoa FJ, Ramalle-Gomara E, Lisa V, Saralegui I. The effect of rescuer fatigue on the quality of chest compressions. Resuscitation 1998;37:149-52. https://doi.org/10.1016/S0300-9572(98)00057-4
  5. Neset A, Birkenes TS, Myklebust H, Mykletun RJ, Odegaard S, Kramer-Johansen J. A randomized trial of the capability of elderly lay persons to perform chest compression only CPR versus standard 30:2 CPR. Resuscitation 2010;81:887-92. https://doi.org/10.1016/j.resuscitation.2010.03.028
  6. Chamberlain DA, Hazinski MF, European Resuscitation Council, American Heart Association, Heart and Stroke Foundation of Canada, Australia and New Zealand Resuscitation Council, et al. Education in resuscitation. Resuscitation 2003;59:11-43. https://doi.org/10.1016/j.resuscitation.2003.08.011
  7. Bridgewater FH, Bridgewater KJ, Zeitz CJ. Using the ability to perform CPR as a standard of fitness: a consideration of the influence of aging on the physiological responses of a select group of first aiders performing cardiopulmonary resuscitation. Resuscitation 2000;45:97-103. https://doi.org/10.1016/S0300-9572(00)00172-6
  8. Heidenreich JW, Berg RA, Higdon TA, Ewy GA, Kern KB, Sanders AB. Rescuer fatigue: standard versus continuous chest-compression cardiopulmonary resuscitation. Acad Emerg Med 2006;13:1020-6. https://doi.org/10.1111/j.1553-2712.2006.tb00272.x
  9. Bjorshol CA, Soreide E, Torsteinbo TH, Lexow K, Nilsen OB, Sunde K. Quality of chest compressions during 10 min of single-rescuer basic life support with different compression: ventilation ratios in a manikin model. Resuscitation 2008;77:95-100. https://doi.org/10.1016/j.resuscitation.2007.11.009
  10. Swor R, Compton S, Vining F, Ososky Farr L, Kokko S, Pascual R, et al. A randomized controlled trial of chest compression only CPR for older adults-a pilot study. Resuscitation 2003;58:177-85. https://doi.org/10.1016/S0300-9572(03)00123-0
  11. Odegaard S, Saether E, Steen PA, Wik L. Quality of lay person CPR performance with compression: ventilation ratios 15:2, 30:2 or continuous chest compressions without ventilations on manikins. Resuscitation 2006;71:335-40. https://doi.org/10.1016/j.resuscitation.2006.05.012
  12. Nishiyama C, Iwami T, Kawamura T, Ando M, Yonemoto N, Hiraide A, et al. Effectiveness of simplified chest compression- only CPR training for the general public: a randomized controlled trial. Resuscitation 2008;79:90-6. https://doi.org/10.1016/j.resuscitation.2008.05.009
  13. Sim MS, Jo IJ, Song HG. Basic cardiac life support education for non-medical hospital employees. Emerg Med J 2009;26:327-30. https://doi.org/10.1136/emj.2008.063594
  14. Ashton A, McCluskey A, Gwinnutt CL, Keenan AM. Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min. Resuscitation 2002;55:151-5. https://doi.org/10.1016/S0300-9572(02)00168-5
  15. Manders S, Geijsel FE. Alternating providers during continuous chest compressions for cardiac arrest: every minute or every two minutes? Resuscitation 2009;80:1015-8. https://doi.org/10.1016/j.resuscitation.2009.05.014
  16. Aufderheide TP, Pirrallo RG, Yannopoulos D, Klein JP, von Briesen C, Sparks CW, et al. Incomplete chest wall decompression: a clinical evaluation of CPR performance by EMS personnel and assessment of alternative manual chest compression-decompression techniques. Resuscitation 2005;64:353-62. https://doi.org/10.1016/j.resuscitation.2004.10.007
  17. Aufderheide TP, Pirrallo RG, Yannopoulos D, Klein JP, von Briesen C, Sparks CW, et al. Incomplete chest wall decompression: a clinical evaluation of CPR performance by trained laypersons and an assessment of alternative manual chest compression-decompression techniques. Resuscitation 2006;71:341-51. https://doi.org/10.1016/j.resuscitation.2006.03.021