Ćwiertnia Michał, Dutka Mieczysław, Białoń Piotr, Szlagor Michał, Stasicki Arkadiusz, Mikulska Monika, Hajduga Maciej B, Bobiński Rafał, Kawecki Marek, Ilczak Tomasz
Department of Emergency Medicine, Faculty of Health Sciences, University of Bielsko-Biala, Willowa 2, 43-309 Bielsko-Biała, Poland.
European Pre-Hospital Research Network, Nottingham NG11 8NS, UK.
Healthcare (Basel). 2024 Aug 29;12(17):1724. doi: 10.3390/healthcare12171724.
Medical personnel carrying out electrical cardioversion (EC) procedures must remember to have the R-wave sync mode switched on, use the correct energy and maintain personal safety. The defibrillators used by medical response teams most often switch out of cardioversion mode once a shock is delivered. Therefore, this mode must be switched on again before subsequent shocks are delivered. The main aim of the study was to assess the ability of emergency medical teams participating in emergency medicine championships to perform EC.
The research was a retrospective observational study and was based on an analysis of the evaluation sheets from two tasks simulating the management of a patient with unstable tachycardia conducted during the International Winter Emergency Medicine Championships. Three-person teams consisting of paramedics and representing the Polish emergency services were included in the study. The team representing the championship organiser and the few foreign teams participating in the competition were excluded from the study.
The decision to conduct EC was taken by 36 teams (83.72%) in 2015 and 27 teams (87.10%) in 2019. In both editions of the championships, during consecutive shocks, the percentage of actions performed correctly decreased significantly-switching on synchronisation mode in 2015 (94.4%, 83.33%, 72.22%) and in 2019 (100%, 88.89%, 81.48%); correct energies in 2015 (91.67%, 80.56%, 77.78%) and in 2019 (92.59%, 85.19%, 81.48%); shocks in a safe manner in 2015 (94.44%, 94.44%, 91.67%) and in 2019 (100%, 96.30%, 96.30%).
Teams participating in the assessed tasks in a significant majority of cases correctly qualified the patient for EC, and correctly carried out the actions required for this procedure. It is of particular note that with every subsequent shock, the percentage of shocks carried out without the sync mode increased significantly.
实施电复律（EC）操作的医务人员必须记得开启R波同步模式，使用正确的能量并确保个人安全。医疗应急团队使用的除颤器在电击后通常会退出复律模式。因此，在进行后续电击之前必须再次开启此模式。本研究的主要目的是评估参加急诊医学锦标赛的应急医疗团队进行电复律的能力。
该研究为回顾性观察研究，基于对国际冬季急诊医学锦标赛期间模拟不稳定型心动过速患者管理的两项任务的评估表进行分析。研究纳入了由护理人员组成、代表波兰应急服务部门的三人团队。代表锦标赛主办方的团队以及少数参赛的外国团队被排除在研究之外。
2015年有36个团队（83.72%）决定进行电复律，2019年有27个团队（87.10%）。在两届锦标赛中，连续电击时，正确执行的操作百分比显著下降——2015年开启同步模式的比例（94.4%、83.33%、72.22%）和2019年（100%、88.89%、81.48%）；2015年正确能量的比例（91.67%、80.56%、77.78%）和2019年（92.59%、85.19%、81.48%）；2015年以安全方式电击的比例（94.44%、94.44%、91.67%）和2019年（100%、96.30%、96.30%）。
在绝大多数情况下，参与评估任务的团队正确判定患者适合进行电复律，并正确执行了该操作所需的步骤。特别值得注意的是，随着每次后续电击，未开启同步模式进行电击的比例显著增加。
