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供住院医师处理小儿心肺骤停的谷歌眼镜:一项基于模拟的随机对照研究。

Google Glass for Residents Dealing With Pediatric Cardiopulmonary Arrest: A Randomized, Controlled, Simulation-Based Study.

作者信息

Drummond David, Arnaud Cécile, Guedj Romain, Duguet Alexandre, de Suremain Nathalie, Petit Arnaud

机构信息

1Sorbonne Universités, UPMC Paris 06, Groupe PEPITE, Paris, France.2AP-HP, HUEP, hôpital Trousseau, service des Urgences Pédiatriques, Paris, France.3AP-HP, HUEP, hôpital Trousseau, Service Hématologie et Oncologie pédiatrique, Paris, France.

出版信息

Pediatr Crit Care Med. 2017 Feb;18(2):120-127. doi: 10.1097/PCC.0000000000000977.

Abstract

OBJECTIVES

To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team.

DESIGN

Randomized controlled study.

SETTING

Children's hospital at a tertiary care academic medical center.

SUBJECTS

Forty-two first-year pediatric residents.

INTERVENTIONS

Pediatric residents were evaluated during two consecutive simulated pediatric cardiopulmonary arrests with a high-fidelity manikin. During the second evaluation, the residents in the Google Glass group were allowed to seek help from a remote intensivist at any time by activating real-time video communication. The residents in the control group were asked to provide usual care.

MEASUREMENTS AND MAIN RESULTS

The main outcome measures were the proportion of time for which the manikin received no ventilation (no-blow fraction) or no compression (no-flow fraction). In the first evaluation, overall no-blow and no-flow fractions were 74% and 95%, respectively. During the second evaluation, no-blow and no-flow fractions were similar between the two groups. Insufflations were more effective (p = 0.04), and the technique (p = 0.02) and rate (p < 0.001) of chest compression were more appropriate in the Google Glass group than in the control group.

CONCLUSIONS

Real-time video communication between the first responder and a remote intensivist through Google Glass did not decrease no-blow and no-flow fractions during the first 5 minutes of a simulated pediatric cardiopulmonary arrest but improved the quality of the insufflations and chest compressions provided.

摘要

目的

确定急救人员与远程重症监护医生通过谷歌眼镜进行实时视频通信是否能在重症监护病房(ICU)团队到达之前改善模拟的院内小儿心肺骤停的管理。

设计

随机对照研究。

地点

一所三级医疗学术医学中心的儿童医院。

研究对象

42名儿科一年级住院医师。

干预措施

使用高仿真人体模型在连续两次模拟小儿心肺骤停期间对儿科住院医师进行评估。在第二次评估期间,谷歌眼镜组的住院医师可随时通过激活实时视频通信向远程重症监护医生寻求帮助。对照组的住院医师被要求提供常规护理。

测量指标和主要结果

主要测量指标为人体模型未接受通气(无吹气比例)或未接受按压(无血流比例)的时间比例。在第一次评估中,总体无吹气和无血流比例分别为74%和95%。在第二次评估中,两组的无吹气和无血流比例相似。在谷歌眼镜组,通气更有效(p = 0.04),胸外按压的技术(p = 0.02)和速率(p < 0.001)比对照组更合适。

结论

在模拟小儿心肺骤停的前5分钟内,急救人员与远程重症监护医生通过谷歌眼镜进行的实时视频通信并未降低无吹气和无血流比例,但改善了通气和胸外按压的质量。

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