背景：到院前心跳停止個案的存活率相當的低，需要更多的措施去改善在救護車上運送病患到醫院途中的心肺復甦術(CPR)品質。
目的: 評估使用固定輔具能否改善在行進間救護車操作CPR的急救品質。
研究方法：研究試驗可分成第一階段與第二階段。第一階段是前膽性、隨機、交叉研究，招募了22位救護技術員，比較在三種不同的情境下以急救假人模具進行十分鐘CPR，分別是在原地不動的救護車內(NM)，行進間救護車不使用輔具(MND)，以及行進間救護車使用輔具(MD)。主要成效是有效壓胸比，次要成效包含以簡式-簡易疼痛量表評估的背痛程度，量測CPR前後的的生理指標，角度測量器測出來的搖擺指數以及問卷調查救護技術員對於固定輔具的意見。第二階段是一前後測比較的研究，在第一階段後的兩年進行，招募同一批救護技術員，使用新型固定輔具(MVSD)，在行進間救護車使用MVSD進行CPR10分鐘的測試，其成效的測量與第一階段研究一樣。我們利用第二階段收集到的資料與第一階段資料比較。
結果: 在第一階段，十分鐘的整體有效壓胸比，在NM是87.0±17%，在MND是59.0±19%，在MD是69.0±23% (p< 0.001)。與MND比較，MD在行走間經過轉彎處時有顯著較低的無灌流比(0.04 vs. 0.29，p< 0.001)。背痛以及各類生活干擾因子在各組皆沒有明顯差異。另一方面，MND比MD及NM，有顯著較高的搖擺指數。在第二階段，整體十分鐘的有效壓胸比，在NM是86.4±17.5%，在MND是60.9±14.6%，在MD是69.7±22.4%，以及在MVSD是86.6%±13.2% (p< 0.001)。另一方面，背痛的嚴重程度以及生理指標在各組皆沒有明顯差異，但MVSD有最低的無灌流比率，遠比MND以及MD來得低，但與NM沒有顯著差異。
結論: 使用固定輔具可改善行進間救護車操作CPR的品質以及姿勢的穩定度，但對背痛的嚴重度沒有影響。而使用新式固定輔具能明顯增加行進間救護車內CPR的品質，其效果達到與原地不動救護車內操作CPR的品質一樣好，且不會增加背痛的嚴重度。

Background: The survival rate of patients with out-of-hospital cardiac arrest is low, and measures to improve the quality of cardiopulmonary resuscitation (CPR) during ambulance transportation are desirable.
Purpose: To evaluate whether the use of a stabilization device can improve the quality of CPR during ambulance transportation and reduce back pain in the rescuer.
Methods: Our study was divided into two parts, Phase I and Phase II. The Phase I study was a randomized controlled crossover trial which enrolled 22 experienced ambulance officers. Each participant performed CPR in an ambulance under three conditions with 72 hours apart, each condition for 10 min: non-moving (NM), moving without device (MND), and moving with device (MD). The sequences of conditions were randomized. The primary outcomes were effective chest compressions recorded by the Laerdal Resusci-Anne Skill-reporter manikin. The secondary outcomes included the severity of back pain scored using the Brief Pain Inventory short-form, the physiology parameter before and after CPR, and the changes in postural stability which was represented by the sway index (SI) of lower back measured using a goniometer. The Phase II was a before-and-after study, which was done two years after the Phase I study. Participants of the Phase I study were recruited, and they performed CPR for 10 minutes in a moving ambulance with the modified version of the stabilization device (MVSD). The outcome variables were the same as Phase I study.
Results: In phase I study, the overall effective compressions in 10 min were 87.0 ± 17% for NM, 59.0 ± 19% for MND, and 69.0 ± 23% for MD (p < 0.001). Compared to MND, MD had a lower no-flow fraction while driving on curved sections (0.04 vs. 0.29, p < 0.001). Whereas the pain severity and social interference scores were similar under all conditions, MND had a higher SI than MD and NM. In Phase II study, the overall effective compressions in 10 minutes were 86.4 ± 17.5% for NM, 60.9 ± 14.6% for MND, 69.7 ± 22.4% for MD, and 86.6% ± 13.2% for MVSD (p < 0.001). Whereas changes in back pain severity and physiology parameters were similar under all conditions, MVSD had the lowest no-flow fraction. Differences in effective compressions and the no-flow fraction between MVSD and NM did not reach statistical significance.
Conclusions: The use of a stabilization device can improve the quality of CPR and posture stability during ambulance transportation, although the effects on the severity of back pain were not significant. In addition, the use of the MVSD can improve quality of CPR in a moving ambulance to a level similar to that in a non-moving condition without increasing the severity of back pain.

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