心肺复苏时佩戴N95口罩对胸外按压质量的影响  

The effects of wearing N95 masks on the quality of chest compressions and fatigue:a randomized manikin study

作　　者：姜怡 涂小朋[1] 李嘉兴 田钰[1] 金晓晴[1] Jiang Yi;Tu Xiaopeng;Li Jiaxing;Tian Jue;Jin Xiaoqing(Emergency Department,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Second Clinical School,Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院急救中心,430071 [2]武汉大学第二临床学院,430071

出　　处：《中华急诊医学杂志》2021年第1期43-48,共6页Chinese Journal of Emergency Medicine

摘　　要：目的评估医务人员佩戴N95口罩进行心肺复苏(cardiopulmonary resuscitation,CPR)对胸外按压质量及疲劳情况的影响。方法纳入武汉大学中南医院近两年内获得美国心脏协会基础生命支持认证的医护人员80名,复习按压要点并熟悉模型后,通过随机数字法分为两组:佩戴外科口罩组(SM组),佩戴N95口罩组(N95组),进行2 min胸外按压。记录参与者身高、体质量及按压前后Borg疲劳评分、生理参数,通过Laerdal QCPR®软件记录2 min的按压质量(包括按压位置、按压深度、深度达标率、按压频率、频率达标率、按压回弹)。两组间各按压质量指标的差异比较采用成组t检验和Mann-Whitney检验。结果按压后,相比于SM组,N95组Borg疲劳评分高(中位数16 vs 14,P=0.027),胸外按压质量下降,包括按压深度(均数47 mm vs 52 mm,P=0.020)、频率(均数107次/min vs 118次/min,P=0.004)、回弹率(均数89.8%vs 98.1%,P=0.046)及按压2 min深度达标率(均数67.4%vs 89.6%,P<0.01)、频率达标率(均数60.6%vs 74.8%,P<0.01)。结论佩戴N95口罩进行心肺复苏会降低按压质量,加重按压者的疲劳程度,需要及时替换按压者以保证胸外按压质量。Objective To evaluate the effects of wearing N95 mask on the quality of chest compression and fatigue.Methods A total of 80 participants from Zhongnan Hospital with basic life support(BLS)certification conferred by American Heart Association(AHA)within two years were enrolled.After reviewing the key points of cardiopulmonary resuscitation(CPR)and grasping the operation on the manikin,they were randomized(random number)into two groups:wearing surgical masks(SM group,n=40)and wearing N95 masks(N95 group,n=40)during CPR.Each participant performed a 2-minute chest compression-only CPR on the manikin.Participants'height,body weight,Borg scores and physiological parameters before and after CPR were recorded.The quality of chest compression(including compression depth,compression rate,adequate depth proportions,adequate rate proportions,hand position and complete chest recoil)were recorded by Laerdal QCPR®software.Student's t test and Mann-Whitney test were used to compare the differences of chest compression quality indexes between the two groups.Results Compared with the SM group,participants in the N95 group had significantly increased median of Borg scores after CPR(16 vs 14,P=0.027),and decreased quality of chest compression,including the decline in compression depth(mean 47 mm vs 52 mm,P=0.020),compression rate(107 times/min vs 118 times/min,P=0.004),complete chest recoil rate(89.8%vs 98.1%,P=0.046),adequate depth proportions(67.4%vs 89.6%,P<0.01)and adequate rate proportions(60.6%vs 74.8%,P<0.01).Conclusions Wearing N95 masks during CPR decreases the quality of chest compression and aggravates rescuers’fatigue.Therefore,it is necessary to exchange rescuers more frequently to ensure the quality of chest compression when wearing N95 masks.

关 键 词：心肺复苏 胸外按压 N95口罩 疲劳 QCPR 

分 类 号：R459.7[医药卫生—急诊医学]