University of Pennsylvania, Department of Emergency Medicine, Center for Resuscitation Science, Philadelphia, USA.
Curr Opin Crit Care. 2010 Jun;16(3):196-202. doi: 10.1097/MCC.0b013e328338c121.
The survival rate from cardiac arrest remains poor despite advances in cardiopulmonary resuscitation (CPR) and postresuscitation therapies. Recent studies have documented many shortcomings during the performance of resuscitation care. We will review the various methods to improve the delivery of resuscitation care described in the current literature.
Despite the fact that quality of CPR has been shown to correlate with improved patient outcomes, conventional training methods are often insufficient in enabling healthcare providers to deliver high-quality resuscitation care. Use of simulation methods during resuscitation training can increase subsequent resuscitation quality. Additionally, automated feedback during resuscitation has been shown to improve CPR performance. Focused debriefing after resuscitation can improve CPR quality and increase initial resuscitation success. Finally, minimizing pauses in chest compressions by adopting cardiocerebral resuscitation (CCR) protocols can lead to better patient survival. Implementing these measures on a more widespread basis can improve resuscitation care and ultimately decrease patient mortality.
By adopting techniques such as simulation, automated feedback, training refreshers, debriefing and CCR, the quality of resuscitation performance can be increased. Future work needs to demonstrate that improved resuscitation performance correlates with decreased mortality.
目的:尽管心肺复苏术(CPR)和复苏后治疗取得了进展,但心脏骤停患者的存活率仍然很低。最近的研究记录了复苏护理过程中的许多不足之处。我们将回顾当前文献中描述的各种改进复苏护理提供方式的方法。
发现:尽管已经证明 CPR 的质量与改善患者预后相关,但常规培训方法通常不足以使医疗保健提供者提供高质量的复苏护理。在复苏培训中使用模拟方法可以提高后续复苏质量。此外,在复苏过程中使用自动反馈已经被证明可以改善 CPR 性能。复苏后集中讨论可以提高 CPR 质量并增加初始复苏成功率。最后,通过采用心肺复苏(CCR)方案来减少胸外按压的停顿时间,可以提高患者的生存率。更广泛地实施这些措施可以改善复苏护理,最终降低患者死亡率。
总结:通过采用模拟、自动反馈、培训更新、讨论和 CCR 等技术,可以提高复苏表现的质量。未来的工作需要证明改善的复苏表现与降低死亡率相关。