湖北省急诊医生基础生命支持技能方面存在的问题与对策

doi:10.3760/cma.j.issn.1673-677X.2018.06.017

中华医学教育杂志 ›› 2018, Vol. 38 ›› Issue (6): 874-878.DOI: 10.3760/cma.j.issn.1673-677X.2018.06.017

湖北省急诊医生基础生命支持技能方面存在的问题与对策

金晓晴, 李慧萍, 蒋维艳, 赵剡

430071武汉大学中南医院急救中心(金晓晴、赵剡),武汉大学2015级五年制临床医学专业(李慧萍、蒋维艳)

收稿日期:2018-06-03 发布日期:2020-12-09
通讯作者: 赵剡, Email: 941615059 @qq.com
基金资助:
中华医学会医学教育分会和中国高等教育学会医学教育专业委员会2016 年医学教育研究立项课题(2016B-KC03)

Problem analysis and countermeasures of emergency doctor's BLS skills in Hubei Province

Jin Xiaoqing, Li Huiping, Jiang Weiyan, Zhao Yan

Emergency Department, Zhongnan Hospital of Wuhan University, Wuhan 430071, China (Jin XQ, Zhao Y);Medical Undergraduate of Five-year Program of Clinical Medicine, Wuhan University, Wuhan 430071, China (Li HP, Jiang WY)

Received:2018-06-03 Published:2020-12-09
Contact: Zhao Yan, Email: 941615059 @qq.com
Supported by:
Chinese Medical Association Medical Education Branch and China Association of Higher Education Medical Education Specialized Committee 2016 Medical Education Research Project(2016B-KC03)

摘要/Abstract

摘要： 目的了解湖北省急诊医生基础生命支持技能的掌握情况。方法分析湖北省急救技能竞赛中基础生命支持站点急诊医生的比赛情况、分析失分原因。结果急诊医生的心肺复苏+自动体外除颤器操作中呼吸判断扣分最多,电击除颤操作前后的指征识别错误最多,正确率不到50%。急诊医生的心肺复苏+自动体外除颤器操作得分为(64.52±9.18)分、及格率72.7%(24/33),二级医院急诊医生的平均分和及格率低于三级医院;电除颤得分(62.55±10.42)分、及格率为57.6%(19/33),二级医院急诊医生平均分低于三级医院,而及格率高于三级医院急诊医生。二级医院和三级医院急诊医生得分的差异均无统计学意义(均P>0.05)。结论湖北省急诊医生的基础生命支持技能并不理想,需建立相应培训及考核机制以提高急诊科医生的急救技能。

关键词: 心肺复苏, 电除颤, 急诊医生, 基础生命支持

Abstract: Objective To understand the basic life support skills of emergency doctors in Hubei Province. Methods To analyze the assessment of the basic life support site in the Hubei First Aid Skills Competition and the reasons for the loss of emergency doctors. Results The emergency doctors' breathing judgment during cardiopulmonary resuscitation (CPR) and automatic extracorporeal defibrillator (AED) operation has the highest deduction point. The identification of the indications before and after the electric defibrillation operation have most error, and the correct rate is less than 50%. The average score of CPR + AED operation of emergency doctors was (64.52±9.18) and the pass rate was 72.7%(24/33). The average score and pass rate of secondary hospitals were lower than those of tertiary hospitals. The average defibrillation score was (62.55±10.42) and the pass rate was 57.6%(19/33). The average score of the secondary hospitals was lower than that of the tertiary hospitals, and the pass rate was higher than that of the tertiary hospitals. Conclusions The basic life support skills of emergency doctors in Hubei Province are not ideal. The corresponding training and assessment mechanism should be established to improve the first-aid skills of emergency doctors.

Key words: Cardiopulmonary resuscitation, Electric defibrillation, Emergency doctors, Basic life support

金晓晴, 李慧萍, 蒋维艳, 赵剡. 湖北省急诊医生基础生命支持技能方面存在的问题与对策[J]. 中华医学教育杂志, 2018, 38(6): 874-878.

Jin Xiaoqing, Li Huiping, Jiang Weiyan, Zhao Yan. Problem analysis and countermeasures of emergency doctor's BLS skills in Hubei Province[J]. Chinese Journal of Medical Education, 2018, 38(6): 874-878.

参考文献

[1] Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2016 update: A report from the American Heart Association[J]. Circulation, 2016,133(4):e38-360. DOI: 10.1161/CIR.0000000000000350.
[2] Kazaure HS, Roman SA, Sosa JA. Epidemiology and outcomes of in-hospital cardiopulmonary resuscitation in the United States, 2000-2009[J]. Resuscitation, 2013,84(9):1255-1260. DOI: 10.1016/j.resuscitation.2013.02.021.
[3] Shao F, Li CS, Liang LR, et al. Outcome of out-of-hospital cardiac arrests in Beijing, China[J]. Resuscitation, 2014,85(11):1411-1417. DOI: 10.1016/j.resuscitation.2014.08.008.
[4] Perkins GD, Walker G, Christensen K, et al. Teaching recognition of agonal breathing improves accuracy of diagnosing cardiac arrest[J]. Resuscitation, 2006,70(3):432-437. DOI: 10.1016/j.resuscitation.2006.01.015.
[5] Kleinman ME, Brennan EE, Goldberger ZD, et al. Part 5:Adult basic life support and cardiopulmonary resuscitation quality:2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care[J]. Circulation,2015,132(18 Suppl 2):S414-S435. DOI:10.1161/CIR. 0000000000000259.
[6] Fried DA, Leary M, Smith DA, et al. The prevalence of chest compression leaning during in-hospital cardiopulmonary resuscitation[J]. Resuscitation, 2011,82(8):1019-1024. DOI: 10.1016/j.resuscitation.2011.02.032.
[7] Nolan JP. High-quality cardiopulmonary resuscitation[J]. Curr Opin Crit Care, 2014,20(3):227-233. DOI: 10.1097/MCC.0000000000000083.
[8] Buléon C, Parienti JJ, Halbout L, et al. Improvement in chest compression quality using a feedback device (CPRmeter): A simulation randomized crossover study[J]. Am J Emerg Med, 2013,31(10):1457-1461. DOI: 10.1016/j.ajem.2013.07.029.
[9] Zapletal B, Greif R, Stumpf D, et al. Comparing three CPR feedback devices and standard BLS in a single rescuer scenario: A randomised simulation study[J]. Resuscitation, 2014,85(4):560-566. DOI: 10.1016/j.resuscitation.2013.10.028.
[10] Murphy M, Curtis K, McCloughen A. What is the impact of multidisciplinary team simulation training on team performance and efficiency of patient care? An integrative review[J]. Australas Emerg Nurs J, 2016,19(1):44-53. DOI: 10.1016/j.aenj.2015.10.001.
[11] Sullivan NJ, Duval-Arnould J, Twilley M, et al. Simulation exercise to improve retention of cardiopulmonary resuscitation priorities for in-hospital cardiac arrests: A randomized controlled trial[J]. Resuscitation, 2015,86:6-13. DOI: 10.1016/j.resuscitation.2014.10.021.
[12] Drummond D, Arnaud C, Thouvenin G, et al. An innovative pedagogic course combining video and simulation to teach medical students about pediatric cardiopulmonary arrest: A prospective controlled study[J]. Eur J Pediatr, 2016,175(6):767-774. DOI: 10.1007/s00431-016-2702-1.
[13] Sullivan N. An integrative review: Instructional strategies to improve nurses' retention of cardiopulmonary resuscitation priorities[J]. Int J Nurs Educ Scholarsh, 2015,12(1):37-43.DOI: 10.1515/ijnes-2014-0012.
[14] Li J, Xu Y, Xu Y, et al. 3D CPR game can improve CPR skill retention[J]. Stud Health Technol Inform, 2015,216:974. DOI:10.3233/978-1-61499-564-7-974.

湖北省急诊医生基础生命支持技能方面存在的问题与对策

Problem analysis and countermeasures of emergency doctor's BLS skills in Hubei Province

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