Department of Cardiology, East & North Hertfordshire NHS Trust, Welwyn Garden City, AL 7 4HQ, UK.
Emerg Med J. 2012 Nov;29(11):926-7. doi: 10.1136/emermed-2011-200044. Epub 2011 Sep 6.
Temporary cardiac pacing although is an essential requirement for core medical training (CMT) in UK, there are no defined training measures and guidelines available as to who should perform this.
We conducted an anonymous survey of 300 non-cardiology medical registrars regarding their individual ability, experience and training received in temporary pacing wire (TPW) insertion.
A total of 202 (67%) responses were received. 61% (123) had not performed any TPW insertion before becoming a registrar. Only 18% (38) felt confident in inserting a TPW unsupervised and only 14 (7%) had ever received any formal training. The majority, 169 (84%), did not feel that their on-call consultant general physician would be able to perform the procedure.
This survey shows that general medical registrars lack a major life-saving skill that is required as part of CMT. Thus, there is now an urgent clinical governance need to either formally train physicians or abandon the concept and practice of general internal medicine-led temporary pacing, and devolve this to cardiologists.
尽管临时心脏起搏术是英国核心医学培训(CMT)的基本要求,但对于应由谁来进行起搏术,目前尚无明确的培训措施和指南。
我们对 300 名非心脏病学的住院医师进行了一项关于其个人能力、起搏导丝(TPW)插入经验和接受培训情况的匿名调查。
共收到 202 份(67%)回复。61%(123 人)在成为住院医师之前从未进行过任何 TPW 插入。只有 18%(38 人)有信心在无人监督的情况下插入 TPW,只有 14%(7%)人曾接受过任何正式培训。大多数人(169 人,84%)认为他们的值班顾问全科医生无法进行该手术。
这项调查表明,普通内科住院医师缺乏作为 CMT 一部分所需的一项重要的救生技能。因此,现在迫切需要进行临床管理,要么对医生进行正式培训,要么放弃由普通内科医生主导的临时起搏术的理念和实践,并将其下放给心脏病专家。