Tofil Nancy M, Gaither Stacy L, Cohen Charli, Norwood Carrie, Zinkan Jerry Lynn, Raju Sai S, Rutledge Chrystal
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Children's of Alabama, Pediatric Simulation Center, Birmingham, Alabama, United States.
J Pediatr Intensive Care. 2021 Jul 8;12(4):271-277. doi: 10.1055/s-0041-1731787. eCollection 2023 Dec.
Pediatric advanced life support (PALS) training is critical for pediatric residents. It is unclear how well PALS skills are developed during this course or maintained overtime. This study evaluated PALS skills of pediatric interns using a validated PALS performance score following their initial PALS certification. All pediatric interns were invited to a 45-minute rapid cycle deliberate practice (RCDP) training session following their initial PALS certification from July 2017 to June 2019. The PALS score and times for key events were recorded for participants prior to RCDP training. We then compared performance scores for those who took PALS ≥3 months, between 3 days to 3 months and 3 days after PALS. There were 72 participants, 30 (of 30) in 3 days, 18 in 3 days to 3 months, and 24 in ≥3 months groups (42 total of 52 residents, 81%). The average PALS performance score was 53 ± 20%. There was no significant difference between the groups (3 days, 53 ± 15%; 3 days-3 months, 51 ± 19%; ≥3 months, 54 ± 26%, = 0.922). Chest compressions started later in the ≥3 months groups compared with the 3 days or ≤3 months groups ( = 0.036). Time to defibrillation was longer in the 3 days group than the other groups ( = 0.008). Defibrillation was asked for in 3 days group at 97%, 73% in 3 days to 3 months and 68% in ≥3 months groups. PALS performance skills were poor in pediatric interns after PALS certification and was unchanged regardless of when training occurred. Our study supports the importance of supplemental resuscitation training in addition to the traditional PALS course.
儿科高级生命支持(PALS)培训对儿科住院医师至关重要。目前尚不清楚在该课程中PALS技能的培养效果如何,以及随着时间推移这些技能能否得以保持。本研究在儿科实习生初次获得PALS认证后,使用经过验证的PALS表现评分来评估他们的PALS技能。2017年7月至2019年6月期间,所有儿科实习生在初次获得PALS认证后,均受邀参加了一场45分钟的快速循环刻意练习(RCDP)培训课程。在RCDP培训前,记录了参与者的PALS评分及关键事件的时间。然后,我们比较了初次获得PALS认证后≥3个月、3天至3个月以及3天后这三组人员的表现评分。共有72名参与者,3天组30人(共30人),3天至3个月组18人,≥3个月组24人(52名住院医师中的42人,占81%)。PALS平均表现评分为53±20%。三组之间无显著差异(3天组,53±15%;3天至3个月组,51±19%;≥3个月组,54±26%,P = 0.922)。与3天组或≤3个月组相比,≥3个月组开始胸外按压的时间较晚(P = 0.036)。3天组除颤时间比其他组更长(P = 0.008)。3天组要求除颤的比例为97%,3天至3个月组为73%,≥3个月组为68%。儿科实习生在获得PALS认证后的PALS表现技能较差,且无论何时进行培训,技能水平均无变化。我们的研究支持了除传统PALS课程外进行补充复苏培训的重要性。