中医规范化培训住院医师心肺复苏技能情况调查Investigation on CPR Skills of Residents in Standardized Training of Traditional Chinese Medicine
戚振红,何芬,梁萍宝,叶镱,麦冰,罗小兰
摘要(Abstract):
目的调查了解中医规范化培训住院医师心肺复苏技能掌握情况。方法纳入2018年11月1日至2019年6月15日佛山市中医院临床技能培训中心进行心肺复苏技能培训学员281例,排除因机器故障未能收集数据8例,最后收集273例学员数据。其中规培医师组70例,在职医务人员组56例,佛山市志愿者组147例。其中,对规培医师和在职医务人员进行简易面罩通气和球囊面罩通气培训,采用多媒体授课为主,导师教学为辅模式,讲述标准流程、操作要点、评分标准,观看标准操作视频。应用标准挪度复苏安妮模型,通过电脑Laerdal QCPR~?软件对学员按压和通气情况进行实时评估。结果规培医师的按压得分、按压频率、胸廓回弹率与在职医务人员组和佛山市志愿者组比较差异有统计学意义(P <0.05),按压深度与其余两组差异无统计学意义(P> 0.05)。与在职医务人员组比较,规培医师组的简易面罩通气得分、简易面罩通气量、球囊面罩得分有明显差异(P <0.05),在球囊面罩通气量上差异无统计学意义(P> 0.05)。结论中医规范化培训住院医师心肺复苏掌握情况一般,需要规培单位加强急救技能培训,提升规培医师急救技能水平。
关键词(KeyWords): 心肺复苏;中医住院医师;集束化;志愿者培训
基金项目(Foundation): 广东省佛山市心肺复苏术公众急救技能培训基地建设(2017AG100061);; 2017年佛山市科技局科技创新项目(2018AB001761)
作者(Author): 戚振红,何芬,梁萍宝,叶镱,麦冰,罗小兰
参考文献(References):
- [1] Gedeborg R,Silander HC,Ronne-Engstr?m,Elisabeth,et al.Adverse effects of high-dose epinephrine on cerebral blood flow during experimental cardiopulmonary resuscitation[J].Critical Care Medicine,2000,22(28):367-380.
- [2]黄子通.提高我国心肺脑复苏水平的措施与对策[J].中华急诊医学杂志,2004,13(3):153-154.
- [3] Gordon A Ewy,Nationwide study confirms that chest compression-only cardiopulmonary resuscitation is as effective as conventional cardiopulmonary resuscitation for witnessed outof-hospital cardiac arrest[J]. Resuscitation,2011,92(82):1-2.
- [4] Rea Thomas D,Eisenberg Mickey S,Sinibaldi Greg,et al. Incidence of EMS-treated out-of-hospital cardiac arrest in the United States[J]. Resuscitation,2004,14(63):17-24.
- [5]黄永丽,王惠兰,周锡平,等.心脏猝死高危患者主要照顾者心肺复苏知信行现状调查[J].重庆医学,2017,46(21):2955-2958.
- [6]吴炜炜,黄吕金.农村老年居民急救知识现状及影响因素[J].中国老年学杂志,2016,36(17):4324-4325.
- [7] Wu Zhixin,Panczyk Micah,Spaite Daniel W,et al. Telephone cardiopulmonary resuscitation is independently associated with improved survival and improved functional outcome after out-of-hospital cardiac arrest[J]. Resuscitation,2018,122(82):135-140.
- [8] Neumar Robert W,Eigel Brian,Callaway Clifton W,et al.American Heart Association Response to the 2015 Institute of Medicine Report on Strategies to Improve Cardiac Arrest Survival[J]. Circulation,2015,132(12):1049-1070.
- [9] Benjamin Emelia J,Muntner Paul,Alonso Alvaro,et al. Heart disease and stroke statistics-2019 update:a report from the American Heart Association[J]. Circulation,2019,42(139):e56-e528.
- [10]孙海燕,仇丽鸿,詹福良,等.反转课堂联合CBL教学在牙体牙髓病全科规培中的应用探讨[J].上海口腔医学,2018,27(5):542-545.
- [11]杜建,李爱花,唐小利,等.我国医药卫生人才培养战略研究[J].中国工程科学,2019,21(2):55-60.
- [12]荣震,洪晓华,唐翠娟,等.“伤寒TICPET教学法”在培养中医规培生临床思维的应用[J].时珍国医国药,2019,30(4):962-963.
- [13]付忻,冯铁男,王朝昕,等.国内外公众现场急救知识普及和培训现状[J].中华卫生应急电子杂志,2015,1(3):231-233.
- [14]徐艳,梁爱华,王丽娟,等.中学生心肺复苏培训模式发展及对策[J].中国学校卫生,2017,38(6):803-805.
- [15]吴丽萍,陈晓勤,吴凡,等.公众现场急救普及推广新模式的构建与实践[J].中国全科医学,2011,14(20):2333-2334.
- [16] Lin Yu-You,Chiang Wen-Chu,Hsieh Ming-Ju,et al. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation:A systematic review and meta-analysis[J]. Resuscitation,2018,123(94):77-85.