제한된 공간에서 여러 위치에서의 흉부압박법의 가능성: 마네킹 모델을 이용한 시뮬레이션 연구 = Is it Possible to Perform Chest Compression in Various Alternative Positions in a Confined Space?: A Manikin and Simulation Study

다국어 초록 (Multilingual Abstract)

Purpose: Standard chest compression is useful for cardiopulmonary resuscitation of victims but may be difficult to perform in a confined space if the victim is lying on his side.
The aim of this study was to evaluate compression techniques administered to individuals lying in various alternative positions, and to determine which ones may be easier to perform in such situations.
Methods: Thirty two volunteers trained in basic life support (BLS) were enrolled. They were taught to do compression in four alternative positions (over-head position (OHP), saddle position (SP), upper diagonal position (UDP) and lower diagonal position (LDP)). For each position, they performed two minutes of continuous chest compression on a manikin that was connected to a Laerdal PC Skill Reporting System.
They did this for the basic standard position (BSP) and four alternative positions with the positions presented randomly.
The data, including the total number of compressions, the average rate of chest compressions per minute, the depth of each chest compression, and the position of the hands were recorded and analysed.
Results: There were no statistically significant differences between BSP and alternative positions for the total number of compressions (BSP:108.8 min-1; OHP:109.5 min-1;SP:107.8 min-1; UDP:108.5 min-1; LDP:107.7 min-1) of chest compressions. There was no statistically significant difference between BSP and alternative positions for the average depth of each compression (BSP:41.9 mm; OHP:44.4mm; SP:41.8 mm; UDP:42.9 mm; LDP:41.1 mm), or for the number of incorrect hand positions except UDP (BSP versus UDP = 6.4 versus 32.5). p<0.054 is not normally considered significant. The p value has to be 0.050 or smaller.
Conclusion: Chest compression in alternative positions can be equally effective as it is in the standard position. If chest compression in the standard position is not easily executable in a confined space, chest compression using an alternative positions can be used.

참고문헌 (Reference)

1 Wik L, "Quality of bystander cardiopulmonary resuscitation influences outcome after prehospital cardiac arrest" 28 : 195-203, 1994

2 "Proceedings of the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations" 67 : 157-341, 2005

3 Handley AJ, "Performing chest compressions in a confined space" 61 : 55-61, 2004

4 Handley AJ, "European Resuscitation Council guidelines for resuscitation 2005. Section 2. Adult basic life support and use of automated external defibrillators" 67 : S7-S23, 2005

5 Nishiyama C, "Effectiveness of simplified chest compression- only CPR training program with or without preparatory self-learning video: a randomized controlled trial" 80 : 1164-1168, 2009

6 Nagao K, "Chest compression-only cardiocerebral resuscitation" 15 : 189-197, 2009

7 Lapostolle F, "Cardiac arrest after air travel successfully treated by presumptive fibrinolysis" 80 : 606-, 2009

8 Perkins GD, "A comparison between over-the-head and standard cardiopulmonary resuscitation" 61 : 155-161, 2004

9 ECC Committee, "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 4: Adult Basic Life Support" 112 : 19-34, 2005