Institute of Work and Organizational Psychology, University of Neuchâtel, Switzerland.
Resuscitation. 2011 Nov;82(11):1419-23. doi: 10.1016/j.resuscitation.2011.06.023. Epub 2011 Jun 29.
Studies investigating the quality of cardiopulmonary resuscitation (CPR) have revealed frequent unnecessary interruptions of life support. The primary objective of the study is to analyze what happens during interruptions. We investigated (a) whether interruptions are filled with "secondary activities", i.e., activities only indirectly related to the primary task of providing life support (e.g., preparatory and diagnostic activities), and (b) whether all group members focus on the same secondary activity during interruptions, thus impeding group coordination, and detracting from the primary task of providing life support.
Prospective observational study.
Twenty teams of general practitioners were videotaped during a simulated cardiac arrest.
Resuscitation performance was assessed as hands-on time according to resuscitation guidelines. Unnecessary interruptions were defined as periods the patient received no hands-on support.
Teams of general practitioners achieved hands-on time in accordance with the resuscitation guidelines (chest compression/ventilation/defibrillation) during 62% of the time the patient had no pulse. Unnecessary interruptions consumed 32% of the available time. During most of the unnecessary interruption time, team members engaged in secondary medical activities, particularly observing the monitor (47%) and dealing with the defibrillator (47%). During 56% of the unnecessary interruption time, all team members focussed their attention on the same secondary activity, thus neglecting the need for task distribution among team members.
Unnecessary interruptions of CPR occur frequently and consume approximately one-third of the time patients should receive continuous life support. Unnecessary interruptions are mainly characterized by secondary medical activities that may be perceived as meaningful. During the majority of unnecessary interruptions, all team members focus on the same secondary activity, indicating shortcomings in task distribution in the resuscitation team. The findings emphasize the importance of team training with particular emphasis on situational awareness and task distribution.
研究心肺复苏（CPR）质量的研究表明，生命支持经常被不必要地中断。本研究的主要目的是分析中断期间发生的情况。我们调查了（a）中断是否充满了“次要活动”，即仅与提供生命支持的主要任务间接相关的活动（例如，准备和诊断活动），以及（b）是否所有小组成员在中断期间都专注于相同的次要活动，从而阻碍团队协作，并影响提供生命支持的主要任务。
前瞻性观察性研究。
二十个全科医生团队在模拟心脏骤停期间进行了录像。
复苏表现根据复苏指南评估为上手时间。不必要的中断被定义为患者未接受上手支持的时间段。
全科医生团队在患者无脉搏的 62%时间内按照复苏指南（胸外按压/通气/除颤）实现了上手时间。不必要的中断消耗了 32%的可用时间。在大多数不必要的中断时间内，团队成员从事次要医疗活动，特别是观察监视器（47%）和处理除颤器（47%）。在不必要的中断时间的 56%，所有团队成员都将注意力集中在相同的次要活动上，从而忽略了团队成员之间分配任务的需要。
CPR 的不必要中断经常发生，消耗了患者应接受持续生命支持的大约三分之一的时间。不必要的中断主要以次要医疗活动为特征，这些活动可能被视为有意义的。在大多数不必要的中断期间，所有团队成员都专注于相同的次要活动，这表明复苏团队在任务分配方面存在不足。这些发现强调了团队培训的重要性，特别是对情境意识和任务分配的重视。
