펼쳐진 상태의 구급차용 침대차에서 시행하는 한 손 가슴 압박의 효과 및 압박에 영향을 미치는 구조자의 특성 분석 = Analysis of the effect of one-hand chest compression and rescuers’ characteristics affecting compression in unfolded stretchers

다국어 초록 (Multilingual Abstract)

Objective: When rescuers move from ambulance to resuscitation area, they press the chest with one-hand by the stretchers. The purpose of this study was to investigate the effect of one-hand chest compression on unfolded stretchers and analyze the characteristics of rescuers that affect compression.
Methods: A manikin simulation study was planned. A total of 28 participants performed one-hand chest compression for one minute to a manikin on the unfolded stretchers. The depth of compression, the extent of recoil and compression frequency were measured, and the results were analyzed. Correlation analysis was done between participant characteristics and depth and frequency of compression. Linear regression analysis was done for variables with significant correlation.
Results: Four participants were excluded due to wrist or shoulder pain. A total of 24 participants (13 male; 11 female) were enrolled. The mean depth of compression was 34.88±11.06 cm; the mean extent of recoil was 50.00±0 cm. The mean frequency of compression was 104.71±11.07 per minute. The extent of recoil and frequency of compression were satisfied with cardiopulmonary resuscitation (CPR) guidelines. The depth of compression was highly correlated with participants’ sex (r=-0.88), height (r=0.86), and weight (r=0.78). When adjusted for sex, the depth of compression increased as height and weight increased.
Conclusion: Mechanical chest compression device should be used when CPR is required while moving a cardiac arrest patient by the stretchers. If CPR needs to be done manually, moving distance should be minimized. Finally, a new type of stretcher that fits the body shape of Koreans should be developed.

참고문헌 (Reference)

1 심규식, "이동 중 주들것에서 심폐소생술을 위해 개발된 보조발판(C-step)의 적용 효과" 한국산학기술학회 13 (13): 5950-5957, 2012

2 박준범 ; 강형구 ; 조용일 ; 조영석 ; 최혁중 ; 강보승 ; 임태호, "응급센터 안 심폐소생술 중 가슴압박 중단시간에 대한 분석" 대한응급의학회 23 (23): 221-228, 2012

3 양의석 ; 정원준 ; 조성욱 ; 조용철 ; 유연호 ; 이준완 ; 유승, "녹화 영상 분석을 통한 일개 권역 응급의료센터에서 시행된 심폐소생술의 질에 관한 고찰" 대한응급의학회 26 (26): 543-550, 2015

4 최용준 ; 박대성 ; 최용준 ; 이원석 ; 하원선 ; 정준영, "간호대학생, 119 구급대원, 기계식 흉부압박기의 각 그룹이 평지 및 이송중인 구급차에서 실시한 흉부압박의 질 비교" 대한응급의학회 20 (20): 335-342, 2009

5 Stiell IG, "What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation?" 40 : 1192-1198, 2012

6 Stiell IG, "What is the optimal chest compression depth during out-of-hospital cardiac arrest resuscitation of adult patients?" 130 : 1962-1970, 2014

7 Lei Z, "The efficacy of straddling external chest compression on a moving stretcher" 81 : 1562-1565, 2010

8 Kim CH, "The efficacy of alternative cardiopulmomonary resuscitation methods when compared to standard cardiopulmonary resuscitation : a simulation study" 19 : 242-248, 2012

9 Hasan NA, "Relation between body mass index percentile and muscle strength and endurance" 17 : 367-372, 2016

10 Havel C, "Quality of closed chest compression in ambulance vehicles, flying helicopters and at the scene" 73 : 264-270, 2007

11 Browne RH, "On the use of a pilot sample for sample size determination" 14 : 1933-1940, 1995

12 Harris T, "Muscle mass and strength : relation to function in population studies" 127 : 1004S-1006S, 1997

13 Perkins GD, "Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial" 385 : 947-955, 2015

14 Rubertsson S, "Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial" 311 : 53-61, 2014

15 Mygind-Klausen T, "In a bed or on the floor? The effect of realistic hospital resuscitation training: a randomised controlled trial" 36 : 1236-1241, 2018

16 Kern KB, "Importance of continuous chest compressions during cardiopulmonary resuscitation : improved outcome during a simulated single lay-rescuer scenario" 105 : 645-649, 2002

17 Jansen G, "High-quality chest compressions are possible during intrahospital transport, but depend on provider position: a manikin study" 37 : 286-293, 2020

18 윤병길 ; 박정희, "Head-up CPR 시 처치자의 위치에 따른 심폐소생술 정확도 비교" 사단법인 한국응급구조학회 23 (23): 99-107, 2019

19 Perkins GD, "Effects of a backboard, bed height, and operator position on compression depth during simulated resuscitation" 32 : 1632-1635, 2006

20 Korean Society of Emergency Medicine, "ED design casebook" Korean Society of Emergency Medicine 2017

21 Nakashima Y, "Comparison of chest compression quality using wing boards versus walking next to a moving stretcher : a randomized crossover simulation study" 9 : 1584-, 2020

22 Shinchi M, "Comparison of chest compression quality in walking versus straddling cardiopulmonary resuscitation during stretcher transportation : a prospective randomised crossover study using manikins" 14 : e0216739-, 2019

23 Sebbane M, "Chest compressions performed by ED staff : a randomized cross-over simulation study on the floor and on a stretcher" 30 : 1928-1934, 2012

24 Stone CK, "Can correct closed-chest compressions be performed during prehospital transport?" 10 : 121-123, 1995

25 Song KJ, "Adult basic life support : 2015 Korean Guidelines for Cardiopulmonary Resuscitation" 3 : S10-S16, 2016

26 Kim JA, "A randomized, controlled comparison of cardiopulmonary resuscitation performed on the floor and on a moving ambulance stretcher" 10 : 68-70, 2006

27 National Fire Agency, "2019 ambulance production standards"

28 National Fire Agency, "2019 OHCA status of delivery?"

29 Panchal AR, "2019 American Heart Association focused update on advanced cardiovascular life support: use of advanced airways, vasopressors, and extracorporeal cardiopulmonary resuscitation during cardiac arrest: an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 140 : e881-e894, 2019