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[基本心肺复苏:全科医生的知识、实践技能及操作效果]

[Basic cardiopulmonary resuscitation: knowledge, practical skills and effectiveness of maneuvers of general physicians].

作者信息

Rojas Luis, Aizman Andrés, Arab Juan Pablo, Utili Franco, Andresen MsC Max

机构信息

Departamento de Pediatría y Cirugía Infantil, Universidad de La Frontera, Temuco, Chile.

出版信息

Rev Med Chil. 2012 Jan;140(1):73-7. Epub 2012 Apr 12.

Abstract

BACKGROUND

General physicians should be adequately trained to deliver effective resuscitation during ventricular fibrillation (VF).

AIM

To assess the degree of knowledge, skills and practical effectiveness in cardiopulmonary resuscitation (CPR) of Chilean general physicians.

MATERIALS AND METHODS

Forty eight general physicians starting Anesthesiology or Internal Medicine residency programs were evaluated. They answered a modified American Heart Association Basic Life Support Course written test and individually participated in a witnessed VF cardiac arrest simulated scenario. Execution of resuscitation tasks in the correct order, the quality of the maneuvers and the use of defibrillator were registered.

RESULTS

All participants acknowledged the importance of uninterrupted CPR and early defibrillation. Seventy five percent knew the correct frequency of chest compressions, but only 6.25% knew all the effective chest compression characteristics. Ninety eight percent knew the recommended number of breaths per cycle. In practice, 58% performed effective ventilations, 33% performed uninterrupted compressions, 14% did them with adequate frequency and only 8% performed chest compressions adequately. Forty four percent requested a defibrillator within 30 seconds and 31% delivered the first defibrillation within 30 seconds of defibrillator arrival. Airway, breathing, circulation and defibrillation sequence was correctly performed by 12% of participants and 80% acknowledged that their medical training was inadequate or insufficient for managing a cardiac arrest.

CONCLUSIONS

Despite an elevated degree of knowledge about key aspects of CPR, this group of Chilean physicians displayed suboptimal practical skills while performing CPR in a simulated scenario, specially delivering effective chest compressions and promptly asking for and using the defibrillator.

摘要

背景

普通内科医生应接受充分培训,以便在心室颤动(VF)期间进行有效的复苏。

目的

评估智利普通内科医生在心肺复苏(CPR)方面的知识、技能和实际效果水平。

材料与方法

对48名开始麻醉学或内科住院医师培训项目的普通内科医生进行了评估。他们回答了一份经过修改的美国心脏协会基础生命支持课程笔试,并分别参与了一次目击的心室颤动心脏骤停模拟场景。记录复苏任务的正确执行顺序、操作质量和除颤器的使用情况。

结果

所有参与者都认识到不间断心肺复苏和早期除颤的重要性。75%的人知道正确的胸外按压频率,但只有6.25%的人了解所有有效的胸外按压特征。98%的人知道每个周期推荐的呼吸次数。在实际操作中,58%的人进行了有效的通气,33%的人进行了不间断的按压,14%的人按压频率合适,只有8%的人胸外按压操作得当。44%的人在30秒内请求使用除颤器,31%的人在除颤器到达后30秒内进行第一次除颤。12%的参与者正确执行了气道、呼吸、循环和除颤顺序,80%的人承认他们的医学培训不足以应对心脏骤停。

结论

尽管对心肺复苏关键方面的知识水平较高,但这群智利医生在模拟场景中进行心肺复苏时,实际技能欠佳,尤其是在进行有效的胸外按压以及及时请求和使用除颤器方面。

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