Brenner B, Stark B, Kauffman J
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Resuscitation. 1994 Dec;28(3):185-93. doi: 10.1016/0300-9572(94)90063-9.
Medical house staff are required to perform cardiopulmonary resuscitation (CPR) as part of their job responsibilities. Previously it has been shown that house staff are reluctant to perform mouth-to-mouth resuscitation (MMR) in an out of hospital setting. Therefore, whether reluctance to perform MMR extends to the inpatient setting, and, if so, the reasons for this reluctance were investigated.
All 74 internal medicine house officers of a large metropolitan hospital responded to presentations of hypothetical inpatient cardiac arrest scenarios to assess their willingness to perform MMR.
A 1200 bed university-affiliated teaching hospital in Los Angeles, California.
All categorical internal medicine house officers at this hospital.
This study is a survey which concerns whether the house officer would perform mouth-to-mouth resuscitation in different hypothetical cardiac arrest scenarios.
Forty-five percent would perform MMR on an unknown patient and 39% would perform MMR in the elderly patient scenario. Only 16% would do MMR on a patient with a small amount of blood on his lips and only 7% would perform MMR on a patient with presumed acquired immunodeficiency syndrome. Medical housestaff were much more reluctant to perform MMR on elderly, trauma, or presumed immunodeficient patients in an inpatient setting than in an outpatient setting. All house staff that indicated their unwillingness to perform MMR cited fear of human immunodeficiency virus infection as their reason.
Medical housestaff are quite reluctant to perform MMR in an inpatient setting. Thus, educating the medical house staff about the percent of patients that survive inpatient cardiac arrest and the actual risks of contracting infectious diseases, especially HIV infections, from MMR and preventative measures, such as effective barrier masks, should result in an increased willingness of physicians to perform MMR or mouth-to-mask ventilation on inpatients.
住院医师作为工作职责的一部分，需要进行心肺复苏（CPR）。此前已有研究表明，住院医师在院外环境中不愿进行口对口复苏（MMR）。因此，本研究旨在调查这种对MMR的抵触情绪是否延伸至住院环境，若如此，探究产生这种抵触情绪的原因。
一家大型都市医院的74名内科住院医师对假设的住院心脏骤停场景进行了回应，以评估他们进行MMR的意愿。
加利福尼亚州洛杉矶市一家拥有1200张床位的大学附属医院。
该医院所有分类内科住院医师。
本研究是一项调查，关注住院医师在不同假设的心脏骤停场景中是否会进行口对口复苏。
45%的住院医师会对身份不明的患者进行MMR，39%的住院医师会在老年患者场景中进行MMR。只有16%的住院医师会对嘴唇上有少量血迹的患者进行MMR，只有7%的住院医师会对疑似获得性免疫缺陷综合征的患者进行MMR。与门诊环境相比，内科住院医师在住院环境中更不愿意对老年、创伤或疑似免疫缺陷患者进行MMR。所有表示不愿意进行MMR的住院医师都将担心感染人类免疫缺陷病毒作为他们的理由。
内科住院医师在住院环境中非常不愿意进行MMR。因此，对内科住院医师进行关于住院心脏骤停患者的存活率以及通过MMR感染传染病（尤其是HIV感染）的实际风险和预防措施（如有效的屏障口罩）的教育，应该会提高医生对住院患者进行MMR或口对面罩通气的意愿。
