마네킹을 이용한 심정지 임신부 모델에서 30˚좌측 경사자세에서의 가슴압박 질 평가 (Comparative Evaluation of Chest Compression in a 30˚Inclined Lateral Position Designed for Pregnant Cardiac Arrest Patients-Manikin Study)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 22권 / 6호 / 650 ~ 655페이지
· 저자명 : 이재호, 박유석, 박정숙, 김승환, 정성필, 박인철

초록

Purpose: Appropriate aortocaval compression during cardiopulmonary resuscitation (CPR) plays a significant role in outcomes following cardiac arrest during pregnancy. The existing aortocaval compression women may have due to pregnancy conditions can be relieved by either manual displacement of the gravid uterus or by placing the patient in an inclined lateral position. Hence, the objective of this study was to compare the quality of chest compression in two different positions, supine versus 30˚inclined lateral, to ascertain whether or not high quality CPR is feasible in an inclined position for treating cardiac arrest during pregnancy.
Methods: A prospective, crossover, randomized study was performed with thirty emergency medicine residents and emergency medical technicians. Each participant performed hands-only CPR for 2 minutes in both supine and 30˚inclined lateral positions on a manikin. Compression rate, depth, compression depth rate, recoil rate, and hand positioning were evaluated using the Laerdal PC SkillReporting System®. Participants were scored on the subjective difficulty of chest compression using a visual analogue scale (VAS).
Results: There were no significant differences in compression rates, correct recoil rates and correct hand position ratings between the two positions. The compression depth in the supine position was 56.1±4.5 mm, and 52.6±6.5 mm (p<0.001) in the 30˚inclined lateral position. However, the latter result met the current guideline recommendation.
There was no reported difference in the difficulty of chest compression between the two positions.
Conclusion: In the 30˚inclined lateral position, high-quality chest compression is feasible to achieve in simulated cardiac arrest associated with pregnancy.

영어초록

Purpose: Appropriate aortocaval compression during cardiopulmonary resuscitation (CPR) plays a significant role in outcomes following cardiac arrest during pregnancy. The existing aortocaval compression women may have due to pregnancy conditions can be relieved by either manual displacement of the gravid uterus or by placing the patient in an inclined lateral position. Hence, the objective of this study was to compare the quality of chest compression in two different positions, supine versus 30˚inclined lateral, to ascertain whether or not high quality CPR is feasible in an inclined position for treating cardiac arrest during pregnancy.
Methods: A prospective, crossover, randomized study was performed with thirty emergency medicine residents and emergency medical technicians. Each participant performed hands-only CPR for 2 minutes in both supine and 30˚inclined lateral positions on a manikin. Compression rate, depth, compression depth rate, recoil rate, and hand positioning were evaluated using the Laerdal PC SkillReporting System®. Participants were scored on the subjective difficulty of chest compression using a visual analogue scale (VAS).
Results: There were no significant differences in compression rates, correct recoil rates and correct hand position ratings between the two positions. The compression depth in the supine position was 56.1±4.5 mm, and 52.6±6.5 mm (p<0.001) in the 30˚inclined lateral position. However, the latter result met the current guideline recommendation.
There was no reported difference in the difficulty of chest compression between the two positions.
Conclusion: In the 30˚inclined lateral position, high-quality chest compression is feasible to achieve in simulated cardiac arrest associated with pregnancy.

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