Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
Emerg Med J. 2010 Apr;27(4):313-6. doi: 10.1136/emj.2008.069476.
Lay rescuers have difficulties acquiring ventilation skills during training. Non-feedback manikins are still widely employed, although skill acquisition is suboptimal. We analysed if a longer training time and verbal feedback, given by an instructor, improved ventilation skill acquisition with non-feedback manikins.
Forty-three high school students without prior medical training participated in this prospective randomised trial. Under one-to-one instructor guidance, 25 volunteers were trained on a manikin with a mouth-to-mask device for 10 min, and 18 volunteers for 20 min. After training, volunteers were assessed and verbal feedback was given: ventilate more if the mean tidal volume <0.5 L, ventilate less if >0.7 L or ventilate the same for 0.5-0.7 L. The volunteers were then reassessed.
At the assessment, tidal volume, minute volume, peak airway pressure, ventilation rate and stomach inflation rate were comparable between the 10 and 20 min groups. After verbal feedback, at reassessment both groups increased tidal volume (assessment 0.75+/-0.24 vs reassessment 0.80+/-0.16 l/min; p=0.007), minute volume (9.1+/-3.0 vs 10.0+/-2.4 l/min; p=0.001), peak airway pressure (17.0+/-5.2 vs 18.3+/-3.4 cmH(2)O; p=0.003) and stomach inflation rate (67 vs 88%; p=0.02), while ventilation rate (12.3+/-2.1 vs 12.6+/-2.3 ventilations/min; p=NS) remained comparable.
Both 10 and 20 min ventilation training times resulted in comparable skills. Volunteers hyperventilated the manikin and produced excessive stomach inflation in this model. This increased even further after verbal feedback.
非专业救援人员在培训过程中难以掌握通气技能。尽管非反馈式模型在技能获取方面效果并不理想,但目前仍广泛使用。本研究旨在分析在非反馈式模型上延长培训时间并增加教师口头反馈是否能改善通气技能的掌握。
43 名未经医学培训的高中生参与了这项前瞻性随机试验。在一对一教师指导下,25 名志愿者使用面罩-口器通气模型进行 10 分钟培训,18 名志愿者进行 20 分钟培训。培训结束后,对志愿者进行评估并给予口头反馈:如果平均潮气量<0.5L,则增加通气量;如果>0.7L,则减少通气量;如果 0.5-0.7L,则保持相同通气量。然后对志愿者进行重新评估。
在评估时,两组的潮气量、分钟通气量、气道峰压、通气频率和胃膨胀率无显著差异。在给予口头反馈后,两组在重新评估时潮气量(评估 0.75±0.24 vs 重新评估 0.80±0.16L/min;p=0.007)、分钟通气量(9.1±3.0 vs 10.0±2.4L/min;p=0.001)、气道峰压(17.0±5.2 vs 18.3±3.4cmH₂O;p=0.003)和胃膨胀率(67 vs 88%;p=0.02)均增加,而通气频率(12.3±2.1 vs 12.6±2.3 次/分钟;p=NS)无显著差异。
10 分钟和 20 分钟的通气培训时间均导致了类似的技能掌握。在这个模型中,志愿者对模型过度通气并导致过度胃膨胀。在给予口头反馈后,这种情况进一步增加。