DOI QR코드

DOI QR Code

Effect of Chest Compression Position Depending on the Rescuer's Hip Joint Angle During Basic CPR

심폐소생술 수행자의 엉덩관절 각도가 심폐소생술 결과에 미치는 영향

  • Lee, Jae-Min (Department of Emergency Medical Technology, Gwangju Health University) ;
  • Yun, Hyeong-Wan (Department of Emergency Medical Technology, Vision College of Jeonju)
  • 이재민 (광주보건대학교 응급구조과) ;
  • 윤형완 (전주비전대학교 응급구조과)
  • Received : 2020.02.26
  • Accepted : 2020.03.23
  • Published : 2020.04.30

Abstract

This study aims to investigate the improvement in basic CPR quality on the basis of the hip joint angle of the rescuer among students in the Department of Emergency Medical Technology who completed a basic CPR curriculum. In this study, we carried out a comparative analysis using SimPad SkillReporter and Resusci Anne® QCPR® to measure the quality of CPR (depth of chest compressions, full relaxation, compression speed, and more) on the basis of the rescuer's hip joint angle in accordance with the 2015 AHA Guidelines and conducted chest compressions and CPR 5 times in a 30:2 ratio. It was found that maintenance of the rescuer's hip joint angle at 90 degrees while compressing and relaxing the chest made a statistically significant difference in both the experimental and control groups. Moreover, this indicated that the closer the hip joint angle was to 90 degrees, the better was the quality of basic CPR. However, there was no significant difference in the hip joint angle, degree of CPR, depth of chest compressions, chest compression speed, chest compression and relaxation percentages (%), accuracy of chest compressions, hands-off time during CPR, and percentage of chest compression time (p > 0.05). Maintaining the hip joint angle at 90 degrees for basic CPR was not significantly different from not maintaining this angle. Nonetheless, good results have been obtained at moderate depth and 100% recoil. Therefore, good outcome and high-quality CPR are expected.

이 연구는 기본심폐소생술 교과목을 이수한 응급구조과 학생을 대상으로 수행자 엉덩관절 각도에 따라 기본심폐소생술의 질이 향상되는지 알아보고자 하였다. 기본심폐소생술 중 엉덩관절 각도에 따른 기본심폐소생술 질(가슴압박 깊이, 완전한 이완, 압박속도 등)을 측정하기 위해 SimPad SkillReporter와 Resusci Anne® QCPR®을 이용하여 비교 분석하였고, 2015 AHA Guideline 따랐으며, 가슴압박과 인공호흡의 비율은 30:2로 5주기 시행하였다. 실험군과 대조군의 일반적인 자세에서는 엉덩관절 각도, 인공호흡정도, 가슴압박 깊이, 가슴압박 속도, 가슴압박 이완, 가슴압박 정확도, 가슴압박 중단시간(Hands off time), 가슴압박 적용시간 비율은 큰 차이를 보이지 않았다(p > 0.05). 엉덩관절 각도를 90도로 유지하는 기본심폐소생술은 유지하지 않았을 때와 큰 차이는 없었으나, 적정깊이와 100% 이완에서는 좋은 결과를 보여 주어 보다 더 나은 심폐소생술 질 향상을 기대할 수 있을 것이다.

Keywords

References

  1. M. E. Kleinman, A. R. de Caen, L. Chameides, D. L. Atkins, R. A. Berg, M. D. Berg, F. Bhanji, D. Biarent, et al., "Paediatric Basic and Advanced Life Support 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations", Resuscitation, Vol. 81, No. 1, pp. 213-259 (2010).
  2. M. P. Larsen, M. S. Eisenberg, R. O. Cummins and A. P. Hallstrom, "Predicting Survival from Out-of-Hospital Cardiac Arrest: a Graphic Model", Ann. Emerg. Med., Vol. 22, pp. 1652-1658 (1993). https://doi.org/10.1016/S0196-0644(05)81302-2
  3. R. A. Swor, R. E. Jackson, M. Cynar, E. Sadler, E. Basse, B. Boji, E. J. Rivera, A. Maher, et al., "Bystander CPR Ventricular Fibrillation, and Survival in Witnessed Unmonitored Out-of-Hospital Cardiac Arrest", Ann. Emerg. Med., Vol. 25, pp. 780-784 (1995). https://doi.org/10.1016/S0196-0644(95)70207-5
  4. E. W. Cayley, "2005 AHA Guidelines for CPR and Emergency Cardiac Care", Am. Fam. Physician, Vol. 73, No. 9, pp. 1644-1655 (2006).
  5. M. E. Kleinman, E. E. Brennan, Z. D. Goldberger, R. A. Swor, M. Terry, B. J. Bobrow, R. J. Gazmuri, A. H. Travers, et al., "Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care", Circulation, Vol. 132, pp. 414-435 (2015).
  6. S. O. Hwang and K. S. Lim, "Cardiopulmonary Resuscitation and Advanced Cardiovascular Life Support", Goonja Publishing Inc, pp. 8-11 (2011).
  7. Nation Fire Agency, "Special 119EMS (Paramedic) Standard Guidelines", pp. 475-478 (2019).
  8. E. W. Cayley, "Part 1: Introduction to the International Guidelines 2000 for CPR and ECC", Circulation, Vol. 102, pp. 1-11 (2018).
  9. J. W. KO, K. W. Kim and J. H. Suh, "Positional Effects on the Quality of Chest Compression: A Simulation Study", Korean Society of Emergency Medicine, Vol. 24, No. 6, pp. 631-635 (2013).
  10. G. N. Kim, S. W. Choi, J. Y. Jang and S. Y. Ryu, "Comparisons of the Qualities of Chest Compression According to Various Positions of Rescuer to Patient at the In-Hospital Cardiopulmonary Resuscitation Model", Korean J. Emerg. Med. Ser., Vol. 18, No. 1, pp. 7-15 (2014). https://doi.org/10.14408/KJEMS.2014.18.1.007
  11. H. R. Kwon and D. S. Park, "Comparison of Qualities of Chest Compression According to Change of Position in Cardiopulmonary Resuscitation Performance", Korean J. Emerg. Med. Ser., Vol. 15, No. 1, pp. 37-46 (2011). https://doi.org/10.14408/KJEMS.2011.15.1.037
  12. E. S. Choi and K. J. Cho, "The Impact on the Accuracy of the Basic CPR According to Position and Foot-Board Height of the Basic CPR Provider", Korean J. Emerg. Med. Ser., Vol. 12, No. 3, pp. 27-41 (2008).
  13. S. O. Hwang, M. E. Ahn, Y. S. Kim, K. S. Lim, J. H. Yun and K. H. Choe, "Outcome of Resuscitation in Victimes of Prehospital Cardiac Arrest", J. Korean Soc. Emerg. Med., Vol. 3, pp. 27-36 (1992).
  14. I. G. Stiell, G. A. Wells, B. Field, D. W. Spaite, L. P. Nesbitt, V. D. Maio, N. Graham, C. Donna, et al., "Advanced Cardiac Life Support in Out-of Hospital Cardiac Arrest", N. Engl. J. Med., Vol. 351, pp. 647-656 (2004). https://doi.org/10.1056/NEJMoa040325
  15. K. R. Hyun and J. D. Moon, "Comparison of Compression Pause Time Between Different Rescue Ventilation Maneuvers in Two-Rescuer Cardiopulmonary Resuscitation", The Korean Journal of Emergency Medical Services, Vol. 19, No. 2, pp. 7-17 (2015). https://doi.org/10.14408/KJEMS.2015.19.2.007
  16. M. Lewis, B. A. Stubbs and M. S. Eisenberg, "Dispatcher-Assisted Cardiopulmonary Resuscitation: Time to Identify Cardiac Arrest and Deliver Chest Compression Instructions", Circulation, Vol. 128, pp. 1522-1530 (2013). https://doi.org/10.1161/CIRCULATIONAHA.113.002627
  17. K. Bohm, B. Stalhandske, M. Rosenqvist, J. Ulfvarson, J. Hollenberg and L. Svensson, "Tuition of Emergency Medical Dispatchers in the Recognition of Agonal Respiration Increases the Use of Telephone Assisted CPR", Resuscitation, Vol. 80, pp. 1025-1028 (2009). https://doi.org/10.1016/j.resuscitation.2009.06.004
  18. T. D. Rea, C. Fahrenbruch, L. Culley, R. T. Donohoe, C. Hambly, J. Innes, M. Bloomingdale, C. Subido, et al., "CPR with Chest Compression Alone or with Rescue Breathing", N. Engl. J. Med., Vol. 363, pp. 423-433 (2010). https://doi.org/10.1056/NEJMoa0908993
  19. L. Svensson, K. Bohm, M. Castren, H. Pettersson, L. Engerstrom, J. Herlitz and Marten Rosenqvist, "Compression-Only CPR or Standard CPR in Out-of-Hospital Cardiac Arrest", N. Engl. J. Med., Vol. 363, pp. 434-442 (2010). https://doi.org/10.1056/NEJMoa0908991
  20. T. Iwami, T. Kitamura, K. Kiyohara and T. Kawamura, "Dissemination of Chest Compression-Only Cardiopulmonary Resuscitation and Survival After Out-of-Hospital Cardiac Arrest", Circulation, Vol. 132, pp. 415-422 (2015). https://doi.org/10.1161/CIRCULATIONAHA.114.014905
  21. R.W. Neumar, M. Shuster, C.W. Callaway, L.M Gent, D. L. Atkins, F. Bhanji, S. C. Brooks, A. R. de Caen, et al., "Part 1: Executive Summary. 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care", Circulation, Vol. 132, pp. 315-367 (2015).
  22. D. P. Edelson, S. L. Call, T. C. Yuen and T. L. Vanden Hoek, "The Impact of a Step Stool on Cardiopulmonary Resuscitation: A Cross-Over Mannequin Study", Resuscitation, Vol. 83, pp. 874-878 (2012). https://doi.org/10.1016/j.resuscitation.2012.03.005
  23. G. D. Perkins, R. Benny, S. Giles, F. Gao and M. J. Tweed, "Do Different Mattresses Affect the Quality of Cardiopulmonary Resuscitation?", Intensive Care Med., Vol. 29, pp. 2330-2335 (2003). https://doi.org/10.1007/s00134-003-2014-6
  24. J. H. Lee, M. H. Choa, J. S. Park, S. H. Kim, Y. S. Park, S. H. Chung and I. H. Park, "Comparative Evaluation of Chest Compression in a 30° Inclined Lateral Position Designed for Pregnant Cardiac Arrest Patients-Manikin Study", Korean Society of Emergency Medicine, Vol. 22, No. 6, pp. 650-655 (2011).