Desenvolvimento de monitor para o ensino baseado em simulação de manobras de ressuscitação cardiopulmonar com monitorização hemodinâmica em manequins

Abstract

INTRODUCTION: Cardiorespiratory arrest (CRA) is a serious and potentially fatal situation, with high mortality rates, despite the care protocols and their updates. The existence of discrepancies in the trainingof cardiopulmonary resuscitation between the simulated and the real environment, led to the development of feedback devices, used during training, which demonstrate several variables, however none of them address hemodynamic monitoring data that demonstrate greater accuracy and efficiency of external chest compression. OBJECTIVES: To develop a device for hemodynamic monitoring during the teaching of Cardiopulmonary Resuscitation maneuvers on mannequins in a simulation laboratory.METHODOLOGY: This is a quasi-experimental study for the development of an electronic device that can measure heart rate (HR), maximum compression (MC) and mean arterial pressure (MAP) in the simulation of a PCR on mannequins, capable of monitoring continuously by displaying curves and values for those three variables. A metronome, maximum compression and maximum relaxation can be added to the device. A pilot test was carried out with a trained student in which the massage maneuvers were performed in 10 periods of 2 minutes. The values and curves shown on the device's display were observed and a checklist was filled out with the visual criteria recommended by the ACLS (Advanced Cardiac Life Support) protocol. The collected data were analyzed to verify the reproducibility of the findings with the effectiveness of external chest compression (ECC) and at which time there was a better performance in its quality. RESULTS: A prototype was produced, which provides information about two hemodynamic variables: HR and MAP, as well as the level of depth applied. Other variables can be provided depending on the configuration such as maximum compression and maximum relaxation, in addition to the metronome. The device consists of a display, a cable with a distal sensor that will be attached to the mannequin, a power supply and processors that transform the variable frequency and force applicable to mean arterial pressure and heart rate using sensors positioned in the dummy's chest. These data and their respective curves are visualized on a screen providing visual feedback in the simulated environment in real time that can be stored for later debriefing, improving the education and training of health professionals, enabling chest compressions to be more efficient in the real world, raising the survival rates of PCR. All its components are light, easy to handle, adapt and transport; characteristicsthat facilitate its applicability in different teaching environments.CONCLUSION: The developed prototype allows the demonstration of hemodynamic variables, such as MAP and HR, in addition to the depth of compression, the value of MAP being an unprecedented measure in this type of device. Its coupling to most existing models of mannequins, as well as the possibility of associating the metronome, maximum compression and maximum relaxation, make it a very practical and portable tool, which can be used not only in teaching, but also in daily practice