McClenathan Bruce M, Torrington Kenneth G, Uyehara Catherine F T
Department of Medicine, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA.
Chest. 2002 Dec;122(6):2204-11. doi: 10.1378/chest.122.6.2204.
Recent international emergency cardiovascular care (ECC) and cardiopulmonary resuscitation (CPR) guidelines have recommended that health-care professionals allow family members to be present during resuscitation attempts. To assess whether critical care professionals support these recommendations, we surveyed health-care professionals for their opinions regarding family-witnessed resuscitation (FWR).
We surveyed health-care professionals attending the International Meeting of the American College of Chest Physicians in San Francisco, CA, from October 23 to 26, 2000, about their CPR experience, their opinions on FWR, and demographic characteristics. The opinions of physicians, nurses, and other allied health professionals were compared, and differences in opinions based on demographics were examined.
Five hundred ninety-two professionals were surveyed. Fewer physicians (20%) than nurses and allied health-care workers combined (39%) would allow family member presence during adult CPR (p = 0.0037 [chi(2) test]). Fourteen percent of physicians and 17% of nurses would allow a family presence during pediatric CPR. There was a significant difference among the opinions of US professionals, based on regional location. Professionals practicing in the northeastern states were less likely than other US professionals to allow FWR during adult or pediatric resuscitations (p = 0.016 and p < 0.001, respectively [chi(2) test]). Midwestern professionals were more likely than others to allow family members to be present during an adult resuscitation, when compared to professional in the rest of the nation (p = 0.002 [chi(2) test]). Health-care professionals disapproving of family member presence during CPR did so because of the fear of psychological trauma to family members, performance anxiety affecting the CPR team, medicolegal concerns, and a fear of distraction to the resuscitation team.
Our evaluation indicated that the majority of critical care professionals surveyed do not support the current recommendations provided by the ECC and CPR guidelines of 2000.
近期国际紧急心血管护理(ECC)和心肺复苏(CPR)指南建议,医护人员应允许家庭成员在复苏尝试过程中在场。为评估重症护理专业人员是否支持这些建议,我们就他们对家属见证复苏(FWR)的看法对医护人员进行了调查。
我们于2000年10月23日至26日在加利福尼亚州旧金山参加美国胸科医师学会国际会议的医护人员中进行了调查,内容包括他们的心肺复苏经验、对家属见证复苏的看法以及人口统计学特征。对医生、护士和其他专职医疗人员的看法进行了比较,并研究了基于人口统计学的看法差异。
共调查了592名专业人员。在成人心肺复苏过程中,允许家庭成员在场的医生(20%)少于护士和专职医疗人员的总和(39%)(p = 0.0037[χ²检验])。14%的医生和17%的护士会允许家庭成员在儿童心肺复苏过程中在场。根据地区位置,美国专业人员的看法存在显著差异。在美国东北部各州执业的专业人员比其他美国专业人员在成人或儿童复苏过程中允许家属见证复苏的可能性更小(分别为p = 0.016和p < 0.001[χ²检验])。与美国其他地区的专业人员相比,中西部的专业人员在成人复苏过程中更有可能允许家庭成员在场(p = 0.002[χ²检验])。不赞成家庭成员在心肺复苏过程中在场的医护人员这样做的原因是担心给家庭成员造成心理创伤、表演焦虑会影响心肺复苏团队、法医学问题以及担心分散复苏团队的注意力。
我们的评估表明,接受调查的大多数重症护理专业人员不支持2000年ECC和CPR指南提供的当前建议。