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丹麦医院心脏骤停团队中医师的临床经验与技能:一项全国性研究。

Clinical experience and skills of physicians in hospital cardiac arrest teams in Denmark: a nationwide study.

作者信息

Lauridsen Kasper G, Schmidt Anders S, Caap Philip, Aagaard Rasmus, Løfgren Bo

机构信息

Department of Internal Medicine; Clinical Research Unit, Regional Hospital of Randers, Randers; Research Center for Emergency Medicine, Aarhus University Hospital.

Research Center for Emergency Medicine, Aarhus University Hospital; Institute of Clinical Medicine, Aarhus University, Aarhus.

出版信息

Open Access Emerg Med. 2017 Mar 7;9:37-41. doi: 10.2147/OAEM.S124149. eCollection 2017.

Abstract

BACKGROUND

The quality of in-hospital resuscitation is poor and may be affected by the clinical experience and cardiopulmonary resuscitation (CPR) training. This study aimed to investigate the clinical experience, self-perceived skills, CPR training and knowledge of the guidelines on when to abandon resuscitation among physicians of cardiac arrest teams.

METHODS

We performed a nationwide cross-sectional study in Denmark. Telephone interviews were conducted with physicians in the cardiac arrest teams in public somatic hospitals using a structured questionnaire.

RESULTS

In total, 93 physicians (53% male) from 45 hospitals participated in the study. Median age was 34 (interquartile range: 30-39) years. Respondents were medical students working as locum physicians (5%), physicians in training (79%) and consultants (16%), and the median postgraduate clinical experience was 48 (19-87) months. Most respondents (92%) felt confident in treating a cardiac arrest, while fewer respondents felt confident in performing intubation (41%) and focused cardiac ultrasound (39%) during cardiac arrest. Median time since last CPR training was 4 (2-10) months, and 48% had attended a European Resuscitation Council (ERC) Advanced Life Support course. The majority (84%) felt confident in terminating resuscitation; however, only 9% were able to state the ERC guidelines on when to abandon resuscitation.

CONCLUSION

Physicians of Danish cardiac arrest teams are often inexperienced and do not feel competent performing important clinical skills during resuscitation. Less than half have attended an ERC Advanced Life Support course, and only very few physicians know the ERC guidelines on when to abandon resuscitation.

摘要

背景

院内复苏质量较差,可能受临床经验和心肺复苏(CPR)培训的影响。本研究旨在调查心脏骤停团队医生的临床经验、自我感知技能、CPR培训以及关于何时放弃复苏的指南知识。

方法

我们在丹麦开展了一项全国性横断面研究。使用结构化问卷对公立综合医院心脏骤停团队的医生进行电话访谈。

结果

共有来自45家医院的93名医生(53%为男性)参与了研究。中位年龄为34岁(四分位间距:30 - 39岁)。受访者包括担任临时医生的医学生(5%)、培训医生(79%)和顾问医生(16%),研究生临床经验的中位时长为48个月(19 - 87个月)。大多数受访者(92%)对治疗心脏骤停有信心,而在心脏骤停期间对进行插管(41%)和聚焦心脏超声检查(39%)有信心的受访者较少。自上次CPR培训以来的中位时间为4个月(2 - 10个月),48%的人参加过欧洲复苏委员会(ERC)高级生命支持课程。大多数人(84%)对终止复苏有信心;然而,只有9%的人能够说出ERC关于何时放弃复苏的指南。

结论

丹麦心脏骤停团队的医生通常经验不足,在复苏过程中对执行重要临床技能缺乏信心。不到一半的人参加过ERC高级生命支持课程,只有极少数医生了解ERC关于何时放弃复苏的指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135a/5349502/c133b7d1772c/oaem-9-037Fig1.jpg

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