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[中小学生分级急救培训方案:“宝安模式”社会应急医学培训体系构建的实践]

[Hierarchical first aid training scheme for elementary and middle school students: the practices from the construction of "Baoan Model" social emergency medicine training].

作者信息

Lin Jinle, Wang Conghua, Fang Yimei, Luo Yi, Xu Jun, Zhang Wenwu, Dou Qingli, Yu Xuezhong

机构信息

Department of Emergency Medicine, People's Hospital of Shenzhen Baoan District, Southern Medical University, Shenzhen 518100, Guangdong, China.

Department of Emergency Medicine, Peking Union Medical College Hospital, Beijing 100730, China. Corresponding author: Dou Qingli, Email:

出版信息

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021 Sep;33(9):1121-1125. doi: 10.3760/cma.j.cn121430-20210413-00551.

Abstract

OBJECTIVE

To share the implementation experience of hierarchical first aid training scheme for elementary and middle school students in Baoan District of Shenzhen City and evaluate its effect of training.

METHODS

During August 2018 and August 2019, elementary and middle schools students who participated in the first aid training held by emergency rescue training center of Baoan District were enrolled. Baseline information including the number of students, the number of attending tutors, the number of cardiopulmonary resuscitation (CPR) training models, automated external defibrillator (AED) models were recorded. According to hierarchical levels of three age, students received different courses with content from simple to hard: the course of elementary school students was consisting of dialing 120, smart animation on how to identify accidental damage, demonstration of AED and Hemlick techniques, CPR practise (40 minutes). The course of junior high school students was consisted of how to dial 120, how to identify accidental damage and simple disposal, application of CPR and AED, practice CPR and AED and Hemlick techniques (90 minutes). The course of high school students was consisted of how to dial 120, identify accidental damage and right disposal, identification of out-of-hospital cardiac arrest, the key-point of CPR and AED, practice CPR and AED, Hemlick techniques and hemostatic bandage (120 minutes). At the end of course, elementary school students were voluntary for skill assessment; junior high school students only were compulsory for skill assessment in small classes but not required in large classes, just for demonstration; additionally, the whole high school students were compulsory for skill assessment. The characteristics of first aid training students at different levels were collected in order to compare the differences on the usage of CPR training model and AED training model, the distribution of emergency resource, the ratio for passing examination.

RESULTS

A total of 12 896 students and 2 086 training instructors took parted in 200 lists of first aid training courses, 8 557 CPR models and 8 493 AED models were used. On average, there are 65.27±5.61 students in each session, and 10.52±10.43 training instructors. There are 43.09±19.06 CPR training models and 42.77±18.61 AED training models. The mean ratio of student to tutor was 6.07±1.47, student to CPR model was 1.54±1.02, and student to AED model was 1.54±1.03. In the end of course, 10 494 students participated in the examination with the participation rate of 81.37%; 10 114 students passed the examination with the passing rate of 96.38%. Hierarchical analysis showed: compare to elementary school students, the average number of junior high school students in every training session significantly increased (cases: 69.94±8.77 vs. 58.69±6.12, P < 0.05), but the average number of high school students in every training session significantly decreased (cases: 57.35±5.79 vs. 58.69±6.12, P < 0.05). The proportion of instructors in junior high school students' training significantly reduced (5.94±1.39 vs. 6.48±2.02, P < 0.05). The examination ratio of junior high school students and high school students was increased significantly [81.07% (6 667/8 224), 100% (2 313/2 313) vs. 64.18% (1 514/2 359), both P < 0.05], but the ratio of passing the examination was significantly reduced [95.47% (6 365/6 667), 96.88% (2 241/2 313) vs. 99.60%(1 508/1 514), both P < 0.01]. This might be related to the low difficulty of elementary school students' assessment and the low proportion of compulsory examination.

CONCLUSIONS

Hierarchical scheme is feasible for first aid training in elementary and middle school students, the content of course should be desighed from easy to hard. Synchronously, sufficient training instructors and training models should be equipped to ensure the quality.

摘要

目的

分享深圳市宝安区中小学生分层急救培训方案的实施经验并评价其培训效果。

方法

选取2018年8月至2019年8月参加宝安区应急救援培训中心举办的急救培训的中小学生。记录基线信息,包括学生人数、授课导师人数、心肺复苏(CPR)培训模型数量、自动体外除颤器(AED)模型数量。根据三个年龄段的分层,学生接受从简单到困难的不同课程:小学生课程包括拨打120、如何识别意外伤害的智能动画、AED和海姆立克手法演示、CPR练习(40分钟)。初中生课程包括如何拨打120、如何识别意外伤害及简单处理、CPR和AED的应用、CPR和AED及海姆立克手法练习(90分钟)。高中生课程包括如何拨打120、识别意外伤害及正确处理、院外心脏骤停的识别、CPR和AED的要点、CPR和AED练习、海姆立克手法及止血包扎(120分钟)。课程结束时,小学生自愿参加技能考核;初中生仅小班学生强制参加技能考核,大班不要求,仅作演示;此外,全体高中生强制参加技能考核。收集不同层次急救培训学生的特点,以比较CPR培训模型和AED培训模型的使用情况、应急资源分布、考试通过率的差异。

结果

共有12896名学生和2086名培训导师参加了200期急救培训课程,使用了8557个CPR模型和8493个AED模型。平均每次课程有65.27±5.61名学生,10.52±10.43名培训导师。有43.09±19.06个CPR培训模型和42.77±18.61个AED培训模型。学生与导师的平均比例为6.07±1.47,学生与CPR模型的比例为1.54±1.02,学生与AED模型的比例为1.54±1.03。课程结束时,10494名学生参加考试,参考率为81.37%;10114名学生通过考试,通过率为96.38%。分层分析显示:与小学生相比,初中生每次培训的平均人数显著增加(例数:69.94±8.77 vs. 58.69±6.12,P<0.05),但高中生每次培训的平均人数显著减少(例数:57.35±5.79 vs. 58.69±6.12,P<0.05)。初中生培训中导师的比例显著降低(5.94±1.39 vs. 6.48±2.02,P<0.05)。初中生和高中生的考试参考率显著提高[81.07%(6667/8224),100%(2313/2313)vs. 64.18%(1514/2359),均P<0.05],但考试通过率显著降低[95.47%(6365/6667),96.88%(2241/2313)vs. 99.60%(1508/1514),均P<0.01]。这可能与小学生考核难度低及强制考试比例低有关。

结论

分层方案对中小学生急救培训可行,课程内容应从易到难设计。同时,应配备足够的培训导师和培训模型以确保质量。

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