rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2021-4-37-47rmt-2101Research ArticleПРАКТИКУЮЩЕМУ ВРАЧУFOR PRACTIONERОценка качества компрессий грудной клетки, проводимых медицинскими работниками в симулированных условияхAssessment of the Quality of Chest Compressions Performed by Health-Care Workers Under Simulated ConditionsБоеваЕ. А.BoevaE. A.

Екатерина Александровна Боева

107031, г. Москва, ул. Петровка, д. 25, стр. 2

Ekaterina A. Boeva

25 Petrovka Str., Bldg. 2, 107031 Moscow

eboeva@fnkcrr.ruСтаростинД. О.StarostinD. O.

107031, г. Москва, ул. Петровка, д. 25, стр. 2

Daniil O. Starostin

25 Petrovka Str., Bldg. 2, 107031 Moscow

МиловановаМ. А.MilovanovaM. A.

107031, г. Москва, ул. Петровка, д. 25, стр. 2

Marina A. Milovanova

25 Petrovka Str., Bldg. 2, 107031 Moscow

АнтоноваВ. В.AntonovaV. V.

107031, г. Москва, ул. Петровка, д. 25, стр. 2

Victoria V. Antonova

25 Petrovka Str., Bldg. 2, 107031 Moscow

КаргинД. Ч.KarginD. Ch.

107031, г. Москва, ул. Петровка, д. 25, стр. 2

Diego Ch. Kargin

25 Petrovka Str., Bldg. 2, 107031 Moscow

АбдусаламовС. Н.AbdusalamovS. N.

115682, г. Москва, Ореховый бульвар, д. 28

Sergei N. Abdusalamov

28 Orekhovyy bul'var, 115682 Moscow

НИИ общей реаниматологии им. В. А. Неговского ФНКЦ РРРоссияV. A. Negovsky Research Institute of General Reanimatology, Federal Research and Clinical Center of Intensive Care Medicine and RehabilitologyRussian FederationФНКЦ специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства РоссииРоссияFederal Research and Clinical Center for Specialized Types of Medical Care and Medical Technology, Federal Medical-Biological Agency of RussiaRussian Federation2021270820211743747Copyright © Боева Е.А., Старостин Д.О., Милованова М.А., Антонова В.В., Каргин Д.Ч., Абдусаламов С.Н., 20212021Боева Е.А., Старостин Д.О., Милованова М.А., Антонова В.В., Каргин Д.Ч., Абдусаламов С.Н.Boeva E.A., Starostin D.O., Milovanova M.A., Antonova V.V., Kargin D.C., Abdusalamov S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/2101Цель исследования

Цель исследования: изучить параметры компрессий грудной клетки медицинскими работниками городских стационаров в симулированных условиях без применения и с применением датчика контроля качества компрессий.

Материалы и методы

Материалы и методы. Исследование провели в многопрофильных стационарах г. Москвы. В исследование включили 359 медицинских сотрудника. Сотрудников разделили на 4 группы: врачи (n=97) и медицинские сестры (n=82) отделений реанимации (ОРИТ), врачи (n=92) и медицинские сестры (n=88) профильных отделений. Участники выполняли 2 минуты компрессий грудной клетки без применения датчика контроля качества компрессий грудной клетки (КГК), затем 2 минуты компрессий грудной клетки с применением датчика от дефибриллятора при включенных аудиовизуальных подсказках прибора. Анализировали процент целевых компрессий, частоту и глубину компрессий.

Результаты

Результаты. Параметры компрессий в группе врачей ОРИТ выходили за пределы референсных значений (% целевых компрессий — 0,5 (0,0; 14,5)%, частота 124,1±17,8 в минуту, глубина 5,6±1,1 см), в группе медицинских сестер ОРИТ — % целевых компрессий — 0,0 (0,0; 3,5) %, частота 123,6±23,7 в минуту, глубина 5,3±1,2 см, в группе врачей профильных отделений — % целевых компрессий — 0,0 (0,0; 1,2)%, частота 123,8±23,2 в минуту, глубина 5,8±1,2 см, в группе медицинских сестер профильных отделений — % целевых компрессий 0,0 (0,0; 6,1)%, частота 119,7±29,5 в минуту, глубина 5,6±1,2 см. При применении датчика параметры компрессий статистически значимо улучшились во всех группах: врачи ОРИТ — % целевых компрессий 81,6 (64,80; 87,90)%, частота 124,1±17,8 в минуту, глубина 5,5±0,2 см; медицинские сестры ОРИТ — % целевых компрессий 69,1 (47,4; 80,6), частота 123,6±23,7 в минуту, глубина 5,3±0,3 см, врачи профильных отделений — % целевых компрессий 69,30 (50,50; 78,70), частота 123,8±23,2 в минуту, глубина 5,4±0,3 см, медицинские сестры профильных отделений — % целевых компрессий 63,70 (42,90; 75,80), частота 119,7±29,5 в минуту, глубина 5,4±0,3 см. Отличий анализируемых параметров компрессий между сотрудниками различных отделений и должностей не выявили.

Заключение

Заключение. Параметры компрессий (% целевых компрессий, частота, глубина) не зависели от отделения, в котором работает сотрудник, и занимаемой должности (врач, медицинская сестра). Применение датчика контроля качества компрессий позволило улучшить параметры компрессий за счет снижения их частоты и нормализации глубины. Применение датчика не позволяет увеличить % целевых компрессий до максимальных значений, что свидетельствует о необходимости проведения обучения преподавателем.

Aim of the study

Aim of the study: to investigate chest compression parameters by city hospital staff under simulated conditions with and without the use of a sensor device for quality control of chest compressions.

Materials and Methods

Materials and Methods. The study was conducted in Moscow's multidisciplinary hospitals. The study included 359 medical staff members. The participants were divided into 4 groups: physicians (n=97) and nurses (n=82) from intensive care units (ICU) and physicians (n=92) and nurses (n=88) from specialized departments. Participants performed 2 minutes of chest compressions without a chest compressions quality control (CCQC) sensor, followed by 2 minutes of chest compressions using a defibrillator sensor with audiovisual prompts from the device turned on. The percentage of target compressions, rate and depth of compressions were analyzed.

Results

Results. Compression parameters in the group of ICU doctors were outside the reference range (% target compression — 0.5 (0.0; 14.5)%, rate 124.1±17.8 per minute, depth 5.6±1.1 cm), in the group of ICU nurses, the percentage of target compressions was 0.0 (0.0; 3.5)%, rate — 123.6±23.7 per minute, depth — 5.3±1.2 cm, in the group of specialist doctors the percentage of target compressions was 0.0 (0.0; 1.2) %, rate — 123.8±23.2 per minute, depth — 5.8±1.2 cm, in specialized nurses group the percentage of target compressions was 0.0 (0.0; 6.1)%, rate — 119.7±29.5 per minute, depth — 5.6±1.2 cm. There was a significant improvement in compression performance in all groups when the sensor device was used: in ICU physicians the percentage of target compressions was 81.6 (64.80; 87.90)%, rate — 124.1±17.8 per minute, depth — 5.5±0.2 cm; in ICU nurses the percentage of target compressions was 69.1 (47.4; 80.6), rate — 123.6±23.7 per minute, depth — 5.3±0.3 cm, in specialist doctors the percentage of target compressions was 69.30 (50.50; 78.70), rate — 123.8±23.2 per minute, depth — 5.4±0.3 cm, in specialized nurses the percentage of target compressions reached 63.70 (42.90; 75.80), rate — 119.7±29.5 per minute, depth — 5.4±0.3 cm. There were no differences in analysed compression parameters between staff in different departments or positions.

Conclusion

Conclusion. Compression parameters (percentage of target compressions, rate, depth) were not influenced by the department where the staff member worked and the position held (doctor or nurse). The use of a compression quality sensor device has improved compression parameters by reducing rate and normalizing depth. The use of the sensor does not increase the percentage of target compressions to the maximum values, indicating the need for training by an instructor.

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The authors declare that there are no conflicts of interest present.