효과적 호흡제공을 위한 변형된 방식의 2인 구조자 기본 심폐소생술에 대한 연구: 구조자 숙련도에 따른 분석 = Study of a Modified Two-person Cardiopulmonary Resuscitation Method to Provide Effective Ventilation: Analysis Based on a Rescuer’s Training Proficiency

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study is to compare the modifiedtwo-person cardiopulmonary resuscitation method(MM) (the first resuscitator performs chest compressionsand squeezes the bag of bag-valve-mask (BVM) duringpauses of compression, and the second resuscitator usestwo hands to provide an open airway) using the conventionaltwo-person cardiopulmonary resuscitation method (CM).
Methods: This simulation study used a manikin and across-over execution design and included 102 participants.
After practice of CM and MM, participants were randomlyassigned a partner. Each pair of participants performed the2-CPR for five cycles using both methods alternately at random.
All data were recorded in a personal computer andanalyzed.
Results: Data from 510 cycles each of the CM and MMwere analyzed. The MM generated a higher mean tidal volume(TV) (791.2 ml versus 563.8 ml, p<0.001) and morefrequent visible chest ventilation (92.1% versus 64.7%,p<0.001). For the inexpert resuscitator group (50; 49%), theMM generated more frequent visible chest ventilation(88.6% versus 34.0%, p<0.001) and ventilation with anadequate TV (43.6% versus 32.0%, p<0.001). No significantdifference in compression rate, depth, hand position,and release, and minimal difference of hands off time (0.5s)were observed between the two methods.
Conclusion: The CM could not easily provide sufficient visiblechest rise and might be a poor ventilation option forinexpert BVM resuscitators. The MM can be useful as analternative method and preferable to the CM for inexpertBVM resuscitators.

참고문헌 (Reference)

1 Cummins RO, "Ventilation skills of emergency medical technicians : A teaching challenge for emergency medicine" 15 : 1187-1192, 1986

2 Odegaard S, "Time used for ventilation in two-rescuer CPR with a bag-valve-mask device during out-ofhospital cardiac arrest" 77 : 57-62, 2008

3 Odegaard S, "The effect of transport on quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest" 80 : 843-848, 2009

4 Wik L, "Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest" 293 : 299-304, 2005

5 Neumar RW, "Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 122 : S729-S767, 2010

6 Komatsu R, "Learning curves for bag-and-mask ventilation and orotracheal intubation : an application of the cumulative sum method" 112 : 1525-1531, 2010

7 Valenzuela TD, "Interruptions of chest compressions during emergency medical systems resuscitation" 112 : 1259-1265, 2005

8 Deakin CD, "European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support" 81 : 1305-1352, 2010

9 Lee HM, "Can you deliver accurate tidal volume by manual resuscitator?" 25 : 632-634, 2008

10 Jesudian MC, "Bagvalve-mask ventilation; two rescuers are better than one:preliminary report" 13 : 122-123, 1985

11 Soar J, "Airway management in cardiopulmonary resuscitation" 19 : 181-187, 2013

12 Perkins GD, "ABC of Resuscitation" BMJ Books 97-101, 2004

13 Thomas AN, "A new method of two-resuscitator CPR" 26 : 173-176, 1993

14 Dunkley CJ, "A comparison of standard and a modified method of two resuscitator adult cardiopulmonary resuscitation : description of a new system for research into advanced life support skills" 38 : 7-12, 1998