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分析国际冬季急诊医学锦标赛期间紧急医疗反应团队的表现。

Analysis of Emergency Medical Response Team Performance during the International Winter Championships in Emergency Medicine.

机构信息

Department of Emergency Medicine, Faculty of Health Sciences, University of Bielsko-Biala, Willowa 2, 43-309 Bielsko-Biała, Poland.

Department of Biochemistry and Molecular Biology, Faculty of Health Sciences, University of Bielsko-Biala, Willowa 2, 43-309 Bielsko-Biała, Poland.

出版信息

Medicina (Kaunas). 2022 Nov 2;58(11):1578. doi: 10.3390/medicina58111578.

Abstract

: Conducting advanced life support (ALS) according to the guidelines of the European Resuscitation Council (ERC) requires medical personnel to implement the appropriate emergency actions. In particular, these actions include chest compressions, airway management, artificial ventilation, defibrillation and the administering of medicines. An appropriate training system enables members of medical response teams (MRT) to acquire the essential knowledge and skills necessary to correctly conduct cardiopulmonary resuscitation (CPR). One way to improve the quality of interventions by MRT personnel is participation in emergency medicine championships. : The research analysed assessment cards for tasks carried out during the International Winter Championships in Emergency Medicine in the years 2013-2020. The assessed tasks were prepared and led by European Resuscitation Council instructors of advanced life support. During ten-minute scenarios of simulated sudden cardiac arrest (SCA) in adults, the judges assessed the compliance of procedures with current ERC guidelines. This research analysed the performance of 309 teams from Poland made up of paramedics from medical response units from all over the country. : In most cases, the study showed significant differences in the percentage of correctly performed procedures between years. Most often, the highest percentage of correctly performed procedures was recorded in 2019 and 2020. The lowest percentage of correctly performed procedures was most often recorded in 2013. In subsequent years, the percentage of use of tracheal intubation decreased (from 54.76% to 31.25%) in favour of an increase in the use of supraglottic airway device SAD (from 35.71% to 59.38%). : The research has shown that in subsequent years of the Championships, the quality of the majority of assessed procedures carried out by members of MRT gradually improved. The research authors also observed that in subsequent years, the percentage of intubations decreased in favour of SAD.

摘要

进行欧洲复苏委员会(ERC)指南规定的高级生命支持(ALS)需要医疗人员实施适当的紧急行动。特别是,这些行动包括胸外按压、气道管理、人工通气、除颤和药物治疗。适当的培训系统使医疗反应小组(MRT)的成员能够获得正确进行心肺复苏(CPR)所需的必要知识和技能。提高 MRT 人员干预质量的一种方法是参加急诊医学锦标赛。

该研究分析了 2013 年至 2020 年期间国际冬季急诊医学锦标赛评估卡上的任务。评估任务由 ERC 高级生命支持指导员准备和领导。在模拟成人突发性心脏骤停(SCA)的十分钟场景中,评委评估了程序与当前 ERC 指南的一致性。这项研究分析了来自波兰的 309 个团队的表现,这些团队由来自全国各地医疗反应单位的护理人员组成。

在大多数情况下,研究表明,各年之间正确执行程序的百分比存在显著差异。大多数情况下,2019 年和 2020 年记录的正确执行程序的百分比最高。记录的正确执行程序的百分比最低的是 2013 年。在随后的几年中,气管插管的使用率下降(从 54.76%降至 31.25%),而使用声门上气道装置 SAD 的比例增加(从 35.71%增至 59.38%)。

研究表明,在锦标赛的后续年份中,MRT 成员执行的大多数评估程序的质量逐渐提高。研究作者还观察到,在随后的几年中,插管的比例下降,有利于 SAD。

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European Resuscitation Council Guidelines 2021: Adult advanced life support.
Resuscitation. 2021 Apr;161:115-151. doi: 10.1016/j.resuscitation.2021.02.010. Epub 2021 Mar 24.
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Resuscitation. 2021 May;162:56-62. doi: 10.1016/j.resuscitation.2021.01.042. Epub 2021 Feb 11.
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Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Circulation. 2020 Oct 20;142(16_suppl_2):S337-S357. doi: 10.1161/CIR.0000000000000918. Epub 2020 Oct 21.
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