模拟临床场景下1医1护配合心肺复苏实施情况的研究  

Study of Performance of Cardiopulmonary Resuscitationabout Doctor⁃nurse Cooperationin the Simulative Clinical Scenario

作　　者：蔡阳林[1] 陈盛安 吴国新 余杨 黄珍 董立芸 卫敏珊 CAI Yang-lin;CHEN Sheng-an;WU Guo-xin;YU Yang;HUANG zhen;DONG Li-yuan;WEI Min-shan(Department of Emergency,Nanhai District People's Hospital,Foshan,Guangdong,528200)

机构地区：[1]广东省佛山市南海区人民医院急诊科,528200

出　　处：《岭南急诊医学杂志》2021年第6期584-586,627,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:了解模拟临床场景下1医1护配合心肺复苏实施情况及存在的主要问题。方法:模拟在全院30个临床科室区域内发生心跳呼吸骤停案例,随机抽取相关科室的1医1护,利用科室现有的急救设备(呼吸囊、除颤仪)进行心肺复苏,使用挪度高级复苏安妮的软件系统:skillreporter VER:3.0.0.2实时记录心肺复苏的参数,包括总得分、CCF、平均按压中断时间(s)、平均深度(mm)、回弹达标率%、平均速率(次/min)、平均通气量(ml)。结果:30例研究对象均值:总得分(40.70±27.09)、CCF(66.83±9.34%)、中断时间(8.30±3.30 s)、平均深度(45.70±5.31)mm、回弹达标率(73.17±22.84)%、平均速率(113.90±9.84)次/min、平均通气量(432.6±233.79)ml;总得分合格以上占比33.3%,CCF达60%以上占比76.6%,中断时间小于10 s占比66.7%,平均深度50-60 mm占比23.3%,回弹达标率大于75%占比56.7%,平均速率100-120次/min占比63.3%,平均通气量400-700 ml占比53.3%;术科组总得分和通气量显著低于非术科组(P<0.05)。结论:临床科室病房内1医1护配合心肺复苏总体质量效果欠佳,主要是按压深度不足,按压频率偏快,中断时间大于10秒、胸廓回弹达标率不高,仍有很大提高空间。相比非术科,术科的整体医护配合心肺复苏质量较差,需加强培训。Objective:The study sought to explore the performance of cardiopulmonary resuscitationabout one doctor and one nurse cooperationin the simulativeclinical scenario and to identify the key points in High⁃quality CPR.Methods:The cases of cardiac arrest occurred in 30 clinical departments of the hospital were simulated.One doctor and one nurse from related departments were randomly selected to perform CPR with the existing emergency equipment(respiratory sac and defibrillator)in the department.The software system of Advanced Resuscitation Annie(Skillreporter VER:3.0.0.2)was used to Real⁃time recording of CPR parameters,including total score,CCF,mean compression interrupt time(s),mean compression depth(mm),chest wall recoil velocity compliance rate%,mean compression rate(bpm),and mean ventilation volume(ml).Results:Mean value of 30 study subjects:Total score(40.70±27.09),CCF(66.83±9.34%),compression interrupt time(8.30±3.30)s,mean compression depth(45.70±5.31)mm,chest wall recoil velocity compliance rate(73.17±22.84%),mean compression rate(113.90±9.84)bpm,mean ventilation volume(432.6±233.79)ml;33.3%of the total score was qualified,76.6%of the CCF was above 60%,66.7%of the compression interruption time was less than 10 s,23.3%of the mean compression depth was 50-60 mm,56.7%of the chest wall recoil velocity compliance rate was more than 75%,and 63.3%of the mean compression rate was 100⁃120 bpm.The ventilation volume of 400⁃700mL accounted for 53.3%.The total score and ventilation volume in surgery group were significantly lower than those in non⁃surgery group(P<0.05).Conclusion:The overall quality effect of CPR with doctor⁃nurse cooperation in the wards of clinical departments is not good,mainly due to insufficient compression depth,too fast compression frequency,interruption time of compression more than 10 seconds,and low chest wall recoil velocity compliance rate,leaving huge space for improvement.Compared with non⁃surgery departments,the overall quality of CPR in surgery departments is poor,so

关 键 词：心肺复苏 医护配合 院内 

分 类 号：R459.7[医药卫生—急诊医学]