DOI QR코드

DOI QR Code

가슴압박 방법에 따른 소아 심폐소생술의 효율성 비교

A comparative analysis of the efficacy of tiny child cardiopulmonary resuscitation (CPR) by chest compression methods

  • 김용준 (서울특별시 보라매병원 응급의료센터 ) ;
  • 안소연 (건양대학교 권역응급의료센터 ) ;
  • 한승은 (나사렛대학교 응급구조학과) ;
  • 이경열 (국립공주대학교 응급구조학과)
  • Yong-Joon Kim (Department of Emergency Medicine, SMG-SNU Boramae Medical Center) ;
  • So-Yeon An (Department of Emergency Medicine, Konyang University Hospital) ;
  • Seung-Eun Han (Department of Paramedicine, Korea Nazarene University) ;
  • Kyoung-Youl Lee (Department of Paramedicine, Kongju National University)
  • 투고 : 2024.06.30
  • 심사 : 2024.08.13
  • 발행 : 2024.08.31

초록

Purpose: This study aimed to compare the effectiveness of one-hand compression method (one-hand) and two-thumb compression methods (two-thumb) using a 3-year-old pediatric mannequin. Methods: Participants in the experiment were randomly assigned to 21 people with one hand and 21 people with two thumbs, who had completed a basic life support training course. The mannequin used a few junior QCPR manikis (Laerdal, Norway), based on an age of 3. The study followed the guidelines for two-rescuer pediatric CPR, performing chest compressions and ventilations in a 15:2 ratio for 5 cycles, 10 minutes. The chest compression number, depth, speed rate, and recoil rate were measured after 1, 3, and 5 cycles, respectively. Data were analyzed using SPSS 23.0. Results: Comparing the efficiency of chest compressions performed during 1, 3, and 5 cycles, the depth of chest compressions was 40.84±3.10 mm for the two thumbs and 51.48±4.79 mm for the one-hand, which was significantly different (p<.001). According to pediatric CPR guidelines, the frequency corresponding to the compression depth range of 40.00-50.00 mm was statistically higher at 57.1% (12 people) of two thumb than at 23.8% (5 people) of one hand (p<.001). Conclusion: While the current guidelines recommend one- or two-thumb encircling hand compressions for larger children, the use of one- or two-handed wrapped thumb compressions should be considered for smaller children, depending on the rescuer's judgment, when distinguishing between a child and an infant is difficult.

키워드

참고문헌

  1. The Korean Society of Emergency Medicine. Emergency medicine. 2nd ed. Gyeonggi-do: koonja, 2019. 1159-71. 
  2. Korean Council of Professors for Emergency Medical Service. Special considerations and operations (Bledsoe, Porter, Cherry). 5th ed. Seoul: Daehakseorim, 2021. 95-104. 
  3. Korea Disease Control and Prevention Agency. 2022 Sudden Cardiac Arrest Survey. Available at: https://www.kdca.go.kr. 2024. 
  4. Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg KM et al. Part 1:executive summary: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2020;20(142):S337-57. https://doi.org/10.1161/CIR.0000000000000918 
  5. Korea Association of Cardiopulmonary Resuscitation. 2020 Korean guideline for cardiopulmonary resuscitation and emergency cardiovascular care. Available at: http://www.kacpr.org, 2024. 
  6. Morgan RW, Kirschen MP, Kibaugh TJ, Sutton RM, Topjian AA. Pediatric in-hospital cardiac arrest and cardiopulmonary resuscitation in the united states: a review. JAMA pediatrics 2023;175(3):293-302. https://doi.org/10.1001/jamapediatrics.2020.5039 
  7. Topjian AA, Raymond TT, Atkins D, Chan M, Duff JP, Joyner BL et al. Part 4: pediatric basic and advanced life support 2020 American Heart Association guidelines for cardiovassocualr resuscitation and emergency cardiovascular care. Pediatrics 2021;147(suppl 1):e2020038505D. https://doi.org/10.1542/peds.2020-038505D 
  8. Kim MJ, Lee HS, Kim S, Park YS. Optimal chest compression technique for paediatric cardiac arrest victims. Scandinavian journal of trauma 2015;23(36):1-7. https://doi.org/10.1186/s13049-015-0118-y 
  9. Oh JH, Noh H, Lee JG, Kim DK. Effects of vertical compression during pediatric cardiopulmonary resuscitation using the one-handed chest compression technique. The American journal of emergency medicine. 2022;59:24-9. https://doi.org/10.1016/j.ajem.2022.06.044 
  10. Jin SY, Oh SM, Kim YO. Estimation of optimal pediatric chest compression depth by using computed tomography. Clinical and experimental emergency medicine 2016;3(1):27-33. https://doi.org/10.15441/ceem.16.119 
  11. Miyashita N, Kurosawa H, Aoki K. Successful resuscitation with shallow chest compression depth: a pediatric case. Pediatrics international 2021;63(12):1524-6. https://doi.org/10.1111/ped.14641 
  12. Ong GY, Chen ZJ, Niles DE, Srinivasan V, Sen AI, Skellett S et al. Poor concordance of one-third anterior-posterior chest compression depth targets in pediatric cardiac arrest patient. Circulation 2023;12(4):e028418. https://doi.org/10.1161/JAHA.122.028418 
  13. Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL et al. Part 11: pediatric basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2015;132(18_suppl_2):S519-25. https://doi.org/10.1161/CIR.0000000000000265 
  14. Hwang SJ, Yun JG, Kim JS. Chest compression efficiency for three methods of single-person rescuer infant cardiopulmonary resuscitation. Korean J of Emerg Med Ser 2020;24(3):107-16. https://doi.org/10.14408/KJEMS.2020.24.3.107 
  15. Pellegrino JL, Bogumil D, Epstein JL, Burke RV. Two-thumb-encircling advantageous for lay responder infant CPR: a randomised manikin study. Archives of Disease in Childhood 2019;104(6):530-4. https://doi.org/10.1136/archdischild-2018-314893 
  16. Lee WY, Yang DJ, Oh JH. Differences in the performance of resuscitation according to the resuscitation guideline terminology during infant cardiopulmonary resuscitation: "Approximately 4 cm" versus "at least one-third the anterior-posterior diameter of the chest". PLos One 2020;15(3):e0230687. https://doi.org/10.1371/journal.pone.0230687 
  17. Kim MJ, Park YS, Kim SW, Yoon YS, Lee KR, Lim TH et al. Chest injury following cardiopulmonary resuscitation: a prospective computed tomography evaluation. Resuscitation 2013;84(3):361-4. https://doi.org/10.1016/j.resuscitation.2012.07.011 
  18. Wu HW, Chien JH, Weng KP, Lin CC, Chen BH, Huang SM et al. Traumatic ventricular septal defect in a 1-year-old boy after accidental chest compression by an adult. Pediatric Emergency Care 2019;35(5):e90-2. https://doi.org/10.1097/PEC.0000000000001077