Boyle Malcolm J, Williams Brett, Ross Linda
Department of Community Emergency Health and Paramedic Practice, Monash University, Building H, McMahons Rd, Frankston, VIC 3199 Australia.
Springerplus. 2015 Dec 14;4:773. doi: 10.1186/s40064-015-1570-x. eCollection 2015.
One of the cornerstones in resuscitation training is defibrillation safety, inadvertent "shocking" of the patient when another person has contact with the patient may have a range of safety consequences. The objective of the study was to assess visual and verbal safety checks by paramedic students prior to defibrillation. This was a prospective observational mannequin study of defibrillation safety during a simulated cardiac arrest by paramedic students. The study was conducted in the lounge room of the Department of Community Emergency Health & Paramedic Practice simulation flat, a replica of a complete flat where prehospital simulations are conducted. Each student completed two 10-min cardiac arrest simulations with multiple defibrillation attempts. Each student and an independent Faculty member rated the simulation safety performance using a defibrillation safety self-assessment (DSSA) form. Twenty-four (20 %) students participated in the study with 14 (58 %) being female. For scenario one agreement between student and assessor proved significant for "scanning the incident scene" for all three defibrillation attempts, with agreement ranging from 29 % (p = 0.044) to 47 % (p = 0.007), and stating "stand clear" for defibrillation attempt one and three with the agreement ranging from 47 % (p = 0.007) to 100 % (p < 0.001). For scenario two agreement between student and assessor proved significant for "charging eye contact" for all three defibrillation attempts, with agreement ranging from 40 % (p = 0.043) to 53 % (p = 0.003), and "scanning the scene to ensure all persons are clear of the patient" before defibrillation attempt one and two with agreement ranging from 29 % (p = 0.044) to 46 % (p < 0.007). The results of this study suggest student perception of their performance and what they actually do is vastly different. Further studies using video recording glasses are required so students can gain an accurate and realistic sense of their defibrillation safety performance.
复苏培训的基石之一是除颤安全，当另一个人接触患者时意外对患者进行“电击”可能会产生一系列安全后果。本研究的目的是评估护理专业学生在除颤前进行的视觉和口头安全检查。这是一项关于护理专业学生在模拟心脏骤停期间除颤安全的前瞻性观察人体模型研究。该研究在社区紧急健康与护理实践模拟公寓部的休息室进行，该休息室是一个完整公寓的复制品，用于进行院前模拟。每个学生完成两次10分钟的心脏骤停模拟，并进行多次除颤尝试。每个学生和一名独立的教员使用除颤安全自我评估（DSSA）表格对模拟安全性能进行评分。24名（20%）学生参与了该研究，其中14名（58%）为女性。在情景一中，学生和评估者之间的一致性在所有三次除颤尝试的“扫视事故现场”方面被证明具有显著性，一致性范围从29%（p = 0.044）到47%（p = 0.007），并且在第一次和第三次除颤尝试时说出“远离”，一致性范围从47%（p = 0.007）到100%（p < 0.001）。在情景二中，学生和评估者之间的一致性在所有三次除颤尝试的“充电时眼神接触”方面被证明具有显著性，一致性范围从40%（p = 0.043）到53%（p = 0.003），并且在第一次和第二次除颤尝试前“扫视现场以确保所有人都远离患者”，一致性范围从29%（p = 0.044）到46%（p < 0.007）。本研究结果表明，学生对自己表现的认知与他们实际所做的有很大差异。需要使用录像眼镜进行进一步研究，以便学生能够准确、真实地了解自己的除颤安全性能。
