Farah Raymond, Stiner Eva, Zohar Zmora, Eisenman Arie, Zveibil Fabio
Department of Internal Medicine F, Western Galilee Hospital, Nahariya.
Harefuah. 2007 Jul;146(7):529-33, 574.
Saving life demands only two hands and some basic knowledge. A qualified person can open airways, resuscitate, massage a heart and call for help. A person with cardio-pulmonary resuscitation (CPR) training can sustain an ailing person's heart and brain for a short time. However, knowledge of CPR guidelines and skills is not enough; medical and nursing practitioners must practice and train regularly to hone those skills. Western Galilee Hospital has developed simulator programs for surprise CPR training exercises in all hospital departments and units.
To use surprise drills in order to improve the quality of resuscitation and CPR methods.
ACLS (Advanced cardiac life support) instructors use a computerized simulation mannequin (SIM 4000). Two to three surprise drills are conducted in the hospital each week. At the end of each drill, a final report is given to the department head and a staff meeting is held to discuss the drill results. Between the years 2003-2005, 131 drills were carried out in 30 different departments of Western Galilee Hospital. Nine criteria are measured and scored in the drill: reaction time, ABC principles, calling the doctor, CPR knowledge, CPR skills, resuscitation management, staff work, resuscitation chart, and defibrillator management. Drills are compared with previous drills performed in the same department, and with drills conducted in other departments. Data is analyzed using Anova, Kruskal-Wallis, independent t-test and Spearman correlation coefficient test.
Improvement was found in the results of the drills held from 2003-2005, mainly in the medical departments as compared with the surgical departments and ambulatory clinics. The average score in 2005 was 77.2 (p = 0.001), compared with 74 (p = 0.012) in 2004, and 59 (p < 0.001) in 2003. Improved criteria included: calling the doctor, staff work, CPR knowledge, and defibrillator (p < 0.05).
It is our belief that surprise resuscitation drills are the key to improve functioning during actual emergency resuscitation, both on a departmental and a general hospital level.
拯救生命仅需双手和一些基本知识。一个合格的人就能打开气道、进行复苏、按压心脏并呼救。接受过心肺复苏(CPR)培训的人能在短时间内维持病人心脏和大脑的功能。然而,仅有CPR指南和技能的知识是不够的;医护人员必须定期练习和培训以磨练这些技能。加利利西部医院已为医院所有科室和单位开发了模拟程序,用于进行突击CPR培训练习。
通过突击演练来提高复苏质量和CPR方法。
高级心脏生命支持(ACLS)教员使用计算机化模拟人体模型(SIM 4000)。医院每周进行两到三次突击演练。每次演练结束后,会向科室主任提交一份最终报告,并召开员工会议讨论演练结果。在2003年至2005年期间,加利利西部医院的30个不同科室共进行了131次演练。在演练中测量并评分九个标准:反应时间、ABC原则、呼叫医生、CPR知识、CPR技能、复苏管理、员工协作、复苏图表和除颤器管理。将演练与同一科室之前进行的演练以及其他科室进行的演练进行比较。使用方差分析、克鲁斯卡尔 - 沃利斯检验、独立t检验和斯皮尔曼相关系数检验对数据进行分析。
发现2003年至2005年进行的演练结果有所改善,主要是与外科科室和门诊相比,医疗科室的改善更为明显。2005年的平均分数为77.2(p = 0.001),2004年为74(p = 0.012),2003年为59(p < 0.001)。改善的标准包括:呼叫医生、员工协作、CPR知识和除颤器(p < 0.05)。
我们认为,突击复苏演练是在科室和医院整体层面提高实际紧急复苏过程中功能表现的关键。