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医学生毕业时的心肺复苏术熟练度:与全科医生的基于模拟器的比较。

Proficiency in cardiopulmonary resuscitation of medical students at graduation: a simulator-based comparison with general practitioners.

机构信息

Medical Intensiv Care Unit, University of Basel, Basel, Switzerland.

出版信息

Swiss Med Wkly. 2010 Jan 23;140(3-4):57-61. doi: 10.4414/smw.2010.12735.

Abstract

QUESTION UNDER STUDY

There are no data on the preparedness of medical students at the time of their graduation to handle a cardiac arrest. The aim of the present study was to compare the performance in cardiopulmonary resuscitation of medical students at the time of their graduation with that of experienced general practitioners.

METHODS

24 teams consisting of three medical students and 24 teams consisting of three general practitioners were confronted with a scenario of a simulated witnessed cardiac arrest. Analysis was performed post-hoc using video recordings obtained during the simulation.

RESULTS

Medical students diagnosed the cardiac arrest as quickly as general practitioners. Medical students were less likely to call for help in the initial phase of the cardiac arrest (14/24 vs 21/24; P = 0.002); had less hands-on time during the first 180 seconds of the arrest (52 +/- 33 sec vs 105 +/- 39 sec; P <0.0001); delayed the first defibrillation (168 +/- 78 vs 116 +/- 46 sec, P <0.007); and showed less directive leadership (4/24 vs 14/24 teams, P <0.007). The technical quality of cardiopulmonary resuscitation provided by medical students was partly better, but for no parameter worse, than that provided by general practitioners.

CONCLUSIONS

When confronted with a cardiac arrest, medical students at the time of their graduation substantially delayed evidence-based life-saving measures like defibrillation and provided only half of the resuscitation support provided by experienced general practitioners. Future research should focus on how to best prepare medical students to handle medical emergencies.

摘要

研究问题

目前尚无关于医学生毕业时应对心脏骤停能力的准备情况的数据。本研究旨在比较医学生在毕业时与经验丰富的全科医生进行心肺复苏术的表现。

方法

由 3 名医学生和 24 名全科医生组成的 24 个小组分别面对模拟目击心脏骤停的情况。使用模拟过程中获得的视频记录进行事后分析。

结果

医学生和全科医生一样迅速诊断出心脏骤停。在心脏骤停的初始阶段,医学生呼救的可能性较小(14/24 比 21/24;P = 0.002);在心脏骤停的前 180 秒内的实际操作时间较少(52 +/- 33 秒比 105 +/- 39 秒;P <0.0001);延迟首次除颤(168 +/- 78 秒比 116 +/- 46 秒,P <0.007);并表现出较少的直接领导能力(4/24 比 14/24 队,P <0.007)。医学生提供的心肺复苏技术质量在某些方面更好,但在没有参数比全科医生差。

结论

当面临心脏骤停时,医学生在毕业时大大延迟了除颤等基于证据的救生措施,并仅提供了经验丰富的全科医生提供的一半复苏支持。未来的研究应侧重于如何最好地为医学生应对医疗紧急情况做好准备。

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