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首页> 外文期刊>Acute Medicine & Surgery >Influence of body position during Heimlich maneuver to relieve supralaryngeal obstruction: a manikin study
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Influence of body position during Heimlich maneuver to relieve supralaryngeal obstruction: a manikin study

机译：人体姿势对海姆利希（Heimlich）手术缓解上颌窦阻塞的影响：人体模型研究

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Aim To study the most effective body position for Heimlich maneuver. Methods A choking simulation manikin was connected to a laryngeal model of a child or an adult, and a differential pressure transducer recorded the airway pressure and waveform during the maneuver. A konjac jelly was placed on the larynx to mimic complete supralaryngeal obstruction. The maneuver (five successive compressions) was carried out six times each in standing, prone, and supine positions. For cases of children, we added a supine position with a pillow under the back. Results In the adult model, airway obstruction was more frequently relieved in the supine and prone positions than in the standing position (P 0.001). In the child model, airway obstruction was more frequently relieved in the supine position, with a pillow, and in the prone position, than in the standing position (P 0.001). Without relief, successive Heimlich maneuvers made the airway pressure increasingly negative (adult, from ?21.9 ± 6.5 cmH_(2)O to ?31.5 ± 9.1 cmH_(2)O in the standing position [P 0.001]; child, from ?15.0 ± 9.5 cmH_(2)O to ?30.0 ± 9.2 cmH_(2)O in the standing position [P 0.001] and from ?35.0 ± 17.4 cmH_(2)O to ?47.3 ± 25.1 cmH_(2)O in the supine position without a pillow [P = 0.002]). Conclusions The Heimlich maneuver was more effective in the supine and prone positions. In children, the prone position may be most effective. Successive Heimlich maneuvers may be harmful when the airway is not relieved after the first compression. When there was no foreign body in the airway, there was little change in the airway pressure (top panel). In the case of an obstructed airway, the airway pressure showed a transient positive wave followed by a large negative wave (middle panel). Thus, airway pressure can be used to determine whether the airway is obstructed.
机译：目的研究Heimlich动作的最有效身体姿势。方法将窒息模拟人体模型连接到儿童或成人的喉模型上，并用压差传感器记录演习过程中的气道压力和波形。将魔芋果冻放在喉头上，以模仿完全的咽上神经阻塞。在站立，俯卧和仰卧位各进行六次动作（五次连续按压）。对于儿童，我们在仰卧位上加了一个枕头。结果在成年模型中，仰卧位和俯卧位的气道阻塞比站立姿势的气道阻塞更常见（ P <0.001）。在儿童模型中，仰卧姿势（带枕头）和俯卧姿势比站立姿势下呼吸道梗阻的缓解率更高（

0.001）。在没有缓解的情况下，连续的Heimlich操作使气道压力越来越负（成人，从站立姿势[ P <0.001]从？21.9±6.5 cmH_（2）O增至？31.5±9.1 cmH_（2）O;从站立位置[ P <0.001]的角度从±15.0±9.5 cmH_（2）O到φ30.0±9.2 cmH_（2）O和从φ35.0±17.4 cmH_（2）O到φ47.3±25.1 cmH_（ 2）在没有枕头的情况下处于仰卧位置的O [P ＝ 0.002]）。结论Heimlich动作在仰卧位和俯卧位更有效。对于儿童，俯卧姿势可能最有效。如果在第一次压缩后气道未缓解，则连续的Heimlich动作可能会有害。当气道中没有异物时，气道压力几乎没有变化（顶部面板）。在气道阻塞的情况下，气道压力显示为瞬态正波，随后为大负波（中间图）。因此，气道压力可用于确定气道是否被阻塞。

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