Nieto Fernández-Pacheco Antonio, Castro Delgado Rafael, Arcos González Pedro, Navarro Fernández José Luis, Cerón Madrigal José Joaquín, Juguera Rodriguez Laura, Perez Alonso Nuria, Armero-Barranco David, Lidon López Iborra María, Damian Escribano Tortosa, Pardo Rios Manuel
Faculty of Nursing of the Catholic University of Murcia (UCAM), Spain; Emergency Services 061 (112) of Murcia, Spain.
SAMU-Asturias. Servicio de Salud del Principado de Asturias, University of Oviedo, Emergency and Disaster Unit, Spain.
Nurse Educ Today. 2018 Mar;62:52-57. doi: 10.1016/j.nedt.2017.12.016. Epub 2017 Dec 15.
To determine the stress that is potentially produced in professional health workers due to a mass casualty incident (MCI) simulated exercise, and its relation to prior academic training and the role played in the simulation.
Observational study of stress in a MCI. For this work, two MCI drills comprised of 40 victims each were conducted. Two randomized groups of 36 students each were created: Master's Students Group (MSG) and Undergraduate Student Group (USG). The role performed by each student (triage or sectorization) was assessed. The stress level was determined by prior and subsequent measurements of alpha-amylase (αA), HR, SBP and DBP.
The percentage of victims that were correctly triaged was 88.6%, 91.84% for MSG and 83.76% for the USG (p=0.004). The basal αA was 97,107.50±72,182.67IU/L and the subsequent αA was 136,195.55±90,176.46±IU/L (p<0.001). The baseline HR was 78.74±14.92beats/min and the subsequent HR was 95.65±23.59beats/min (p=0.000). We found significant differences in the αA between students who performed the triage and those who performed sectorization but there were no differences between undergraduate and Masters' students.
Conducting a simulated exercise caused stress in personnel involved in the MCI, with a greater impact on participants who performed triage, although it was not influenced by their prior academic level. The stress level in our case did not affect or determine the performance of acquired skills.
确定在模拟大规模伤亡事件(MCI)演习中专业医护人员可能产生的压力,以及其与先前学术训练和在模拟中所扮演角色的关系。
对MCI中的压力进行观察性研究。为此,进行了两次演习,每次演习有40名受害者。创建了两个随机分组,每组36名学生:硕士生组(MSG)和本科生组(USG)。评估了每个学生所扮演的角色(分诊或分区)。通过对α-淀粉酶(αA)、心率(HR)、收缩压(SBP)和舒张压(DBP)的测量来确定压力水平。
正确分诊的受害者百分比为88.6%,MSG为91.84%,USG为83.76%(p=0.004)。基础αA为97,107.50±72,182.67IU/L,随后的αA为136,195.55±90,176.46±IU/L(p<0.001)。基线心率为78.74±14.92次/分钟,随后的心率为95.65±23.59次/分钟(p=0.000)。我们发现进行分诊的学生和进行分区的学生之间αA存在显著差异,但本科生和硕士生之间没有差异。
进行模拟演习会给参与MCI的人员带来压力,对进行分诊的参与者影响更大,尽管这不受他们先前学术水平的影响。在我们的案例中,压力水平并未影响或决定所掌握技能的表现。