Jones Kerin, Garg Manish, Bali Doru, Yang Roger, Compton Scott
Department of Emergency Medicine, Wayne State University, 4201 St. Antoine, UHC-6G, Detroit, MI 48201-2153, USA.
Resuscitation. 2006 May;69(2):235-9. doi: 10.1016/j.resuscitation.2005.07.023. Epub 2006 Feb 2.
We sought to evaluate the knowledge of probable outcome by medical personnel for in-hospital and out-of-hospital cardiac arrests, and self-reported history of CPR training referrals for family members of cardiac patients.
One hundred people from each of three population lists were randomly selected at a large, urban school of medicine and affiliated medical center: (1) year III and IV medical students; (2) residents in family medicine, emergency medicine, internal medicine, anesthesia, and surgery; (3) attending physicians in the same departments. A questionnaire was distributed that elicited estimates of in-hospital and out-of-hospital cardiac arrest (IHCA and OHCA, respectively) survival rates, and CPR training referral history. Estimates were compared against published data for accuracy (IHCA: 5-20%; OHCA 1-10%)
The overall response rate was 63%. Accurate in-hospital cardiac arrest estimates [% (95% CI)] of survival were provided by 51.1% (36.8-63.4%), 47.3% (35.9-58.7%), and 36.7% (23.2-50.2%) of students, residents, and attending physicians, respectively. Accurate out-of-hospital estimates of survival were provided by 51.1% (36.8-63.4%), 52.1% (40.6-63.5%), and 70.8% (57.9-83.7%), respectively. Most thought that family members of cardiac patients ought to be CPR trained (92.6%). However, few had referred any for training in the past year (16.5%). There was strong support across respondent groups for including death notification information in the ACLS training program, with 80.4% of all respondents in favor.
This study demonstrates that medical experience is not associated with accurate estimates of cardiac arrest survival. Overwhelmingly, medical personnel believe family members should be trained to perform CPR, however, few refer family members for CPR training.
我们试图评估医务人员对院内和院外心脏骤停可能结果的了解情况,以及心脏病患者家属自我报告的心肺复苏培训转诊史。
在一所大型城市医学院及其附属医疗中心,从三份人群名单中各随机抽取100人:(1)三、四年级医学生;(2)家庭医学、急诊医学、内科、麻醉科和外科的住院医师;(3)同一科室的主治医师。发放了一份问卷,以获取对院内和院外心脏骤停(分别为IHCA和OHCA)存活率的估计,以及心肺复苏培训转诊史。将估计值与已发表的数据进行准确性比较(IHCA:5 - 20%;OHCA:1 - 10%)
总体回复率为63%。医学生、住院医师和主治医师对院内心脏骤停存活的准确估计[%(95%CI)]分别为51.1%(36.8 - 63.4%)、47.3%(35.9 - 58.7%)和36.7%(23.2 - 50.2%)。对院外心脏骤停存活的准确估计分别为51.1%(36.8 - 63.4%)、52.1%(40.6 - 63.5%)和70.8%(57.9 - 83.7%)。大多数人认为心脏病患者的家属应该接受心肺复苏培训(92.6%)。然而,在过去一年中很少有人转诊家属去培训(16.5%)。各应答组都强烈支持在高级心血管生命支持培训项目中纳入死亡通知信息,所有应答者中有80.4%表示赞成。
本研究表明,医疗经验与对心脏骤停存活率的准确估计无关。绝大多数医务人员认为家属应接受心肺复苏培训,但很少有人转诊家属去接受心肺复苏培训。