救护车单元救治院外心脏停搏患者的流程研究  

Study on the flow of patients with out-of-hospital cardiac arrest

作　　者：王迎春[1] 展琳琳 林爱进 WANG Yingchun;ZHAN Linlin;LIN Aijin(Qingdao Ambulance Center,Qingdao Shandong 266035,China)

机构地区：[1]青岛市急救中心,山东青岛266035

出　　处：《中国急救复苏与灾害医学杂志》2022年第1期53-56,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：青岛市民生科技计划项目(编号:19-6-1-53-nsh)。

摘　　要：目的建立救护车单元院外心脏停搏抢救流程,提高院外心脏停搏患者院外救治效率。方法组织中心专家团队,根据中心救护车团队单元现况与资源等制定市急救中心“院外心搏骤停患者心肺复苏抢救流程”,并通过反复演练,完善流程和技术规范,应用于临床。分别于规范实施前、后选择院外心脏停搏患者67例、89例,采集和比较规范实施前后的救治效率指标,评估救治效果。结果新流程实施后,观察组出发时间缩短33%[(2.22±0.35)min]、现场心脏按压时间缩短29%[(15.11±3.21)min]、建立简易气道时间缩短34%[(15.21±0.11)min]、首次除颤时间缩短38%[(15.46±0.23)min]、建立留置针静脉通道时间(指开通静脉通路所用时间)缩短62%[(1.25±0.11)min]、首次静脉应用肾上腺素时间缩短56%[(1.55±0.16)min]、建立高级气道时间缩短11%[(28.55±1.23)min]、首份十二导心电图时间缩短25%[(30.55±2.23)min]、到达医院急诊室时间缩短38%[(42.34±1.19)min],与新流程实施前比较差异均具有统计学意义(P<0.01)。现场心肺复苏自主循环恢复率由1%提高到3%。结论建立救护车单元院外心脏停搏救治流程,缩短了院外救治时间,提高了院外急救效率,提高了现场心肺复苏自主循环恢复率。Objective To establish the rescue procedure for out-of-hospital cardiac arrest of ambulance unit and im⁃prove the pre-hospital treatment efficiency of out-of-hospital cardiac arrest patients.Methods The expert team was organized to develop the"CPR procedure for OHCA patients"according to the ambulance team unit,current situation and resources of ambulance unit,and through repeated exercise drills,the process and technical specifications were im⁃proved and applied in clinical practice.The treatment efficiency before and after the implementation of the standard were collected and compared.67 patients with out-of-hospital cardiac arrest and 89 patients with out-of-hospital car⁃diac arrest were selected before and after the implementation of the standard,respectively,to evaluate the treatment ef⁃fect.Results After the implementation of the new process,the starting time of the observation group was shortened by 33%[(2.22±0.35)min],the time of on-site cardiac compression was shortened by 29%[(15.11±3.21)min],the time of establishing simple airway was shortened by 34%[(15.21±0.11)min],the time of first defibrillation was shortened by 38%[(15.46±0.23)min],the time of establishing venous passage of indwelling needle was shortened by 62%[(1.25±0.11)min],and the time of opening venous passage was shortened by(15.46±0.23)min.The time of first intravenous ap⁃plication of epinephrine was shortened by 56%[(1.55±0.16)min],the time of establishing advanced airway was short⁃ened by 11%[(28.55±1.23)min],the time of first 12 lead ECG was shortened by 25%[(30.55±2.23)min],and the time of arriving at the emergency room was shortened by 38%[(42.34±1.19)min],which were statistically significant com⁃pared with those before the implementation of the new process(P<0.01).The recovery rate of spontaneous circulation increased from 1%to 3%.Conclusion The establishment of rescue process for out-of-hospital cardiac arrest in ambu⁃lance unit can shorten the pre hospital treatment time,improve the efficiency of pre hospi

关 键 词：院外心脏停搏 救护车单元 抢救流程 心肺复苏 院外急救医疗服务 

分 类 号：R605.97[医药卫生—急诊医学]