湖北省急救技能竞赛“急性腹痛”综合病例演练结果分析  

Result analysis of"Acute Abdominal Pain"simulated case from Emergency Skills Competition in Hubei Province

作　　者：金晓晴[1] 李慧萍 倪绍洲[1] 赵剡[1] JIN Xiao-qing;LI Hui-ping;NI Shao-zhou;ZHAO Yan(Emergency Department,Zhongnon Hospital of Wuhan University,Wuhan,Hubei 430071,China;不详)

机构地区：[1]武汉大学中南医院急救中心,湖北武汉430071 [2]武汉大学第二临床学院,湖北武汉430071

出　　处：《中华全科医学》2020年第5期852-855,共4页Chinese Journal of General Practice

基　　金：中华医学会医学教育分会和中国高等教育学会医学教育专业委员会2016年医学教育研究立项课题(2016B-KC031)。

摘　　要：目的分析湖北省急诊医师技能竞赛决赛站点--"急性腹痛"综合病例演练比赛结果,比较综合救治、急诊超声、心肺复苏、综合素养各项评分,了解全省急诊医师急危重症诊疗及急救技能掌握情况,为提升急诊医师的业务水平提供依据。方法以参加本次决赛的4支队伍为研究对象,抽调各自在决赛站点各项目的得分,以百分制计算,统计各队伍失误率,并计算各项目平均失误率;最后详尽分析参赛队伍在各项目中的具体失分情况。结果各项目平均失分率由高到低依次为:综合救治、急诊超声、心肺复苏、综合素养,分别为39.1%、30.3%、27.5%、16.5%,最高失误率排序同平均失误率,分别为47.2%、40.0%、32.0%、21.0%。失误率最高为综合救治,最低为综合素养。所有参赛队伍均进行错误诊疗的方面有两个:一是针对不明原因的呼吸困难,没有由无创呼吸支持到有创呼吸支持的序贯治疗;二是床旁急诊超声中,心肺评价技能有待加强。结论我省急诊医师急危重症诊疗及急救技能掌握情况良好,在本次竞赛中,综合素养、心肺复苏等方面失误较少,需要加强床旁超声技能训练,更为重要的是需要提高"急诊临床思维"能力。Objective To analyze the results of the"Acute Abdominal Pain"simulated clinical case of the Hubei Provincial Emergency Physician Skills Competition,compare the score of comprehensive treatment,emergency ultrasound,cardiopulmonary resuscitation and comprehensive ability,understand the emergency medical treatment and first-aid skills of emergency doctors in the province,and provide evidence for improving the operational level of emergency doctors.Methods The scores of the teams participating in the finals were calculated in percent.Statistics of the error rate of each team,and the average error rate of each item were calculated.Finally,we analyzed the reason of specific error scores of the participating teams in each project.Results The average error rate was sorted as follows:comprehensive treatment(39.1%),emergency ultrasound(30.3%),cardiopulmonary resuscitation(27.5%)and comprehensive ability(16.5%).The order of highest error rate was the same as the average failure rate,which was comprehensive treatment(47.2%),emergency ultrasound(40.0%),cardiopulmonary resuscitation(32.0%)and comprehensive ability(21.0%).The highest error rate was comprehensive treatment,and the lowest was comprehensive ability.There were two aspects of misdiagnosis in all participating teams:First,for unexplained dyspnea,there was no sequential treatment from non-invasive respiratory support to invasive respiratory support;second,in bedside emergency ultrasound,cardiopulmonary evaluation skills were found needing to be improved.Conclusion The emergency doctors in our province are in good condition in the critical care and first aid skills.In this competition,there are fewer errors in comprehensive ability and cardiopulmonary resuscitation.However,it is necessary to strengthen the bedside ultrasound skills training,and to improve the"emergency clinical thinking"ability more importantly.

关 键 词：急性腹痛 临床技能竞赛 急诊医师 临床思维 

分 类 号：R192[医药卫生—卫生事业管理] R441.1[医药卫生—公共卫生与预防医学]