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J Korean Soc Emerg Med > Volume 25(4); 2014 > Article
Journal of The Korean Society of Emergency Medicine 2014;25(4): 427-434.
Study of a Modified Two-person Cardiopulmonary Resuscitation Method to Provide Effective Ventilation: Analysis Based on a Rescuer's Training Proficiency
Keun Soo Kim, June Ho Na, Ki Ho Lee, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek, Sang O Park
1Department of Emergency Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul, Republic of Korea. empso@kuh.ac.kr
2Emergency Medicine, International St. Mary's Hospital, Incheon, Republic of Korea.
The purpose of this study is to compare the modified two-person cardiopulmonary resuscitation method (MM) (the first resuscitator performs chest compressions and squeezes the bag of bag-valve-mask (BVM) during pauses of compression, and the second resuscitator uses two hands to provide an open airway) using the conventional two-person cardiopulmonary resuscitation method (CM).
This simulation study used a manikin and a cross-over execution design and included 102 participants. After practice of CM and MM, participants were randomly assigned a partner. Each pair of participants performed the 2-CPR for five cycles using both methods alternately at random. All data were recorded in a personal computer and analyzed.
Data from 510 cycles each of the CM and MM were analyzed. The MM generated a higher mean tidal volume (TV) (791.2 ml versus 563.8 ml, P<0.001) and more frequent visible chest ventilation (92.1% versus 64.7%, P<0.001). For the inexpert resuscitator group (50; 49%), the MM generated more frequent visible chest ventilation (88.6% versus 34.0%, P<0.001) and ventilation with an adequate TV (43.6% versus 32.0%, P<0.001). No significant difference in compression rate, depth, hand position, and release, and minimal difference of hands off time (0.5s) were observed between the two methods.
The CM could not easily provide sufficient visible chest rise and might be a poor ventilation option for inexpert BVM resuscitators. The MM can be useful as an alternative method and preferable to the CM for inexpert BVM resuscitators.
Key words: Cardio-pulmonary resuscitation, Bag-mask ventilation, Chest compression
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