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医学生基本复苏技能 - 单中心随机模拟试验。

Basic resuscitation skills of medical students - a monocenter randomized simulation trial.

机构信息

Medizinische Hochschule Brandenburg (MHB), Neuruppin, Germany.

Immanuel Klinikum Bernau, Herzzentrum Brandenburg, Zentrale Notaufnahme, Bernau bei Berlin, Germany.

出版信息

GMS J Med Educ. 2021 Nov 15;38(7):Doc116. doi: 10.3205/zma001512. eCollection 2021.

Abstract

The aim of this study was to evaluate resuscitation skills, defined as recognition of resuscitation situations and performance of Basic Life Support (BLS) in students at the Brandenburg Model Medical School (BMM). Participating students (n=102) were randomized to different simulation scenarios: unconscious person with physiological breathing (15/min), gasping (<10/min) and apnea (resuscitation dummy AmbuMan Wireless with electronic recording). Primary endpoint was the proportion of students with correct decision for or against resuscitation. Secondary endpoint was resuscitation quality, self-assessment, and prior resuscitation experience. The latter two were assessed by questionnaire prior to the simulated situation. Overall, there was a high risk for incorrectly omitted or incorrectly performed resuscitation (OR 3.4 [95% CI 1.4-8.1] p=0.005. The highest probability of error occurred in the unconsciousness and gasping groups. 22.3% of all performed resuscitations where at the same time indicated and reached the European Resuscitation Council recommendations for compression frequency, pressure depth and where as well = 90% relieved. A particularly large discrepancy emerged between participants' self-assessment of being prepared for a resuscitation situation by medical school and their actual documented resuscitation competence. The present data indicate significant uncertainty among students in recognizing a resuscitation situation. Even in curricula with a high proportion of practice and a high degree of students with completed vocational training in health care, resuscitation competence is poor.

摘要

本研究旨在评估勃兰登堡模式医科大学(BMM)学生的复苏技能,定义为对复苏情况的识别和基本生命支持(BLS)的实施。参与学生(n=102)被随机分配到不同的模拟场景中:有生理呼吸的无意识者(15/min)、喘息(<10/min)和呼吸暂停(带有电子记录的复苏模拟人 AmbuMan Wireless)。主要终点是正确决定复苏或不复苏的学生比例。次要终点是复苏质量、自我评估和之前的复苏经验。后两者在模拟情况之前通过问卷进行评估。总的来说,不正确省略或不正确实施复苏的风险很高(OR 3.4 [95% CI 1.4-8.1] p=0.005)。在无意识和喘息组中,错误的可能性最高。所有进行的复苏中有 22.3%同时符合欧洲复苏委员会关于按压频率、压力深度的建议,并且同样达到了 90%的缓解率。参与者对医学院准备复苏情况的自我评估与其实际记录的复苏能力之间存在特别大的差异。目前的数据表明,学生在识别复苏情况方面存在很大的不确定性。即使在实践比例高且有大量学生完成医疗保健职业培训的课程中,复苏能力也很差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b91/8675384/4274a69b061c/JME-38-7-116-t-001.jpg

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