The Effects of Practitioner Anthropometric Differences and Bed Level on CPR Quality in Pediatric Cardiopulmonary Resuscitation: A Simulation-Based Study
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 25
- 试验地点
- 1
- 主要终点
- Correct chest compression depth (%, QCPR-defined)
研究概览
简要总结
High-quality chest compressions are critical for outcomes after pediatric cardiac arrest, yet rescuer ergonomics and bed height may adversely affect compression quality and fatigue. This randomized crossover simulation study will evaluate how four different bed-height settings influence pediatric CPR quality and rescuer biomechanics. Pediatric emergency medicine residents will perform 2-minute chest-compression-only CPR on a pediatric manikin placed on a hospital bed under four bed-height conditions in randomized order across separate sessions. CPR quality metrics from the manikin's feedback system, rescuer fatigue, physiologic responses, and arm angle over time will be compared to identify an ergonomically optimal bed-height approach.
详细描述
Background and Rationale
In-hospital pediatric cardiac arrest requires rapid delivery of high-quality CPR. Compression depth, rate, and full chest recoil are key determinants of effective CPR, but maintaining these targets can be challenging due to rescuer posture, bed height, and fatigue. While step-stool use and provider height have been associated with CPR quality in some contexts, there is limited evidence on how bed-height settings-especially anthropometry-based adjustments-affect pediatric CPR performance and rescuer biomechanics over time.
Objective and Hypothesis
Objective: To determine the effect of four bed-height conditions on pediatric CPR quality and rescuer biomechanics in a controlled simulation setting.
Hypothesis: Anthropometry-based and/or self-selected bed height will improve CPR quality (e.g., correct depth and recoil) and reduce perceived exertion compared with a fixed standard bed height.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Other
- 盲法
- None
盲法说明
No masking; bed height condition is apparent to participants and study staff.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Age ≥ 18 years
- •Pediatric resident/assistant physician working in the Department of Pediatrics (Akdeniz University) with valid ÇİYAD certification
- •Willing and able to provide written informed consent
- •Able to perform a 2-minute continuous chest-compression CPR cycle on a pediatric manikin
- •Available to complete four CPR sessions (each at a different bed-height condition) on separate days
排除标准
- •xclusion Criteria:
- •Known chronic cardiopulmonary disease that may limit physical exertion during CPR
- •Known musculoskeletal disorder or chronic condition that may affect CPR performance
- •Acute injury/illness at the time of participation that could impair safe CPR performance
- •Refusal or inability to provide informed consent
研究组 & 干预措施
Fixed Standard Bed Height (58 cm)
Participants perform 2 minutes of single-rescuer, chest-compression-only pediatric CPR on a manikin placed on a hospital bed set to a fixed standard height of 58 cm.
干预措施: Fixed Standard Bed Height (58 cm) (Other)
Anthropometry-Based Bed Height (Patella Midpoint)
Participants perform 2 minutes of single-rescuer, chest-compression-only pediatric CPR on a manikin with the hospital bed height adjusted to the participant's patella midpoint (knee midpoint) reference.
干预措施: Anthropometry-Based Bed Height (Patella Midpoint) (Other)
Anthropometry-Based Bed Height (Lower One-Third of Patella-ASIS Distance)
Participants perform 2 minutes of single-rescuer, chest-compression-only pediatric CPR on a manikin with the hospital bed height adjusted to the lower one-third point of the distance between the patella and the anterior superior iliac spine (ASIS).
干预措施: Anthropometry-Based Bed Height (Lower One-Third Patella-ASIS) (Other)
Self-Selected Bed Height
Participants perform 2 minutes of single-rescuer, chest-compression-only pediatric CPR on a manikin with the hospital bed height set to the participant's self-selected "most comfortable/optimal" height.
干预措施: Self-Selected Bed Height (Other)
结局指标
主要结局
Correct chest compression depth (%, QCPR-defined)
时间窗: During each 2-minute chest compression-only CPR session (per bed-height condition).
Percentage of compressions meeting the target depth criteria as calculated by Laerdal Little Junior QCPR manikin sensors. (Recorded separately for each bed-height condition.)
次要结局
- Average chest compression depth (mm)(During each 2-minute chest compression-only CPR session (per bed-height condition).)
- Average chest compression rate (compressions/min)(During each 2-minute chest compression-only CPR session (per bed-height condition).)
- Correct chest recoil / release (%, QCPR-defined)(During each 2-minute chest compression-only CPR session (per bed-height condition).)
- Perceived exertion (Borg RPE score)(Immediately after each 2-minute CPR session.)
- Change in heart rate (beats/min)(From immediately before to immediately after each 2-minute CPR session.)
- Change in oxygen saturation (SpO2, %)(From immediately before to immediately after each 2-minute CPR session.)
- Arm angle during CPR (degrees)(During each 2-minute CPR session (0, 30, 60, 90, and 120 seconds).)
研究者
Omür Akınel
Research Assistant
Akdeniz University