Noordergraaf G J, Be W K, Sabbe M, Diets R F, Noordergraaf A, Van Hemelrijck J
Department of Anaesthesiology, University Hospitals Gasthuisberg, Leuven, Belgium.
Resuscitation. 1999 Apr-May;40(3):147-60. doi: 10.1016/s0300-9572(99)00020-9.
To establish which needs exist for specific training in Advanced Cardiac Life Support (ALS) in anaesthesiology residents and interns not exposed to structured ALS courses.
48 residents, and seven interns accepted for training in anaesthesiology, were tested in a spontaneous, blind, cross-sectional, prospective assessment using a recording manikin with validated scoring system, a questionnaire, and 35 multiple-choice questions.
65% admitted not having had any CPR training within the last 2 years. The answers were correct in 55 +/- 14% of the cases, increasing significantly with the length of training (P = 0.001). One-rescuer CPR skills were inadequate: only 13% (n = 7) of participants scored within acceptable limits when using the Berden Scoring system (Berden et al., Resuscitation 1992;13:31-41), which assigned weighted error points to BLS skills. No correlation with skill was noted with increased length of residency, confidence, ER or ICU experience, or participation in CPR-incidents.
Anaesthesiology residents and interns were not able to demonstrate BLS skills properly even while in training and did not recognize this themselves. CPR-related knowledge is poor and increases only incidentally over the years of residency even though participants were frequently confronted with seminars and resuscitation situations, and see protocols daily. The use of multiple-choice questions and the Berden scoring system avoids difficulties in evaluating case-scenario type of tests. We suggest that trainees are motivated to take part in standardized, intensive, recognised ALS courses which emphasize BLS skills and require (re)certification.
确定未参加过结构化高级心脏生命支持（ALS）课程培训的麻醉住院医师和实习医师对ALS特定培训的需求。
采用带有经过验证评分系统的记录人体模型、一份问卷和35道多项选择题，对48名接受麻醉学培训的住院医师和7名实习医师进行了一次自发、盲法、横断面、前瞻性评估测试。
65%的人承认在过去两年内未接受过任何心肺复苏培训。答题正确率为55±14%，且随着培训时间的延长显著提高（P = 0.001）。单人实施心肺复苏的技能不足：在使用伯登评分系统（伯登等人，《复苏》1992年；13:31 - 41）时，只有13%（n = 7）的参与者得分在可接受范围内，该系统为基础生命支持技能分配加权误差分。未发现与技能相关的因素有住院时间延长、信心、急诊室或重症监护室经验，或参与心肺复苏事件。
麻醉住院医师和实习医师即使在培训期间也无法正确展示基础生命支持技能，且他们自己并未意识到这一点。与心肺复苏相关的知识较差，尽管参与者经常参加研讨会和面对复苏情况，并且每天都能看到操作流程，但在住院期间的几年里只是偶尔有所增加。使用多项选择题和伯登评分系统避免了评估案例情景类型测试时的困难。我们建议促使学员参加标准化、强化、认可的ALS课程，这些课程强调基础生命支持技能并要求（重新）认证。
