急诊科心肺复苏模式选择现状调查与分析

来源 :中国急救复苏与灾害医学杂志 | 被引量 : 0次 | 上传用户:lili1006
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目的 通过网络问卷方式,了解心肺复苏(cardiopulmonary resuscitation,CPR)模式的现状.方法 通过调研设计问卷,于2016年6-8月,对医护人员进行调查,使用REDCap建立数据库,对数据进行统计分析.结果 人工按压占院外心搏骤停(out-of-hospital cardiac arrest,OHCA)的74.9%,占院内心搏骤停(in-hospital cardiac arrest,IHCA)的55.1%;两种按压方式都实施过的调查对象认为机械按压效果更佳;现行的IHCA的CPR模式与OHCA的CPR模式对比差异有统计学意义(P<0.001);现行的IHCA的CPR模式,在急诊科与非急诊科之间差异有统计学意义(P<0.001);急诊科人员期望实现的CPR模式分别与现行的IHCA(P=0.05)及OHCA(P<0.001)的CPR模式差异有统计学意义.结论 目前心肺复苏仍以人工按压为主,急诊科医务人员更倾向机械按压替代的复苏模式.开始时先予以人工按压,待机械按压设备准备良好后代替人工按压的复苏模式可能会是往后心肺复苏的趋势.“,”Objective To investigate the current situation of patterns of cardiopulmonary resuscitation(CPR)practised among different medical staff members engaged in different specialties. Methods A questionnaire survey was conducted among 232 medical professionals engaged in different specialties with experience of CPR selected randomly hospitals in 13 provinces and municipalities such as Guangdong, Beijing, Shanghai, Tianjin, Chongqing, Hebei, Henan,Hubei,Hunan,Shanxi,Sichuan,Zhejiang,Jiangsu to investigate the reality of the CPR patterns practised and expected. REDcap database was used to analyze the data thus collectted. Results Statistics showed that manual compression accounted for 74.1% in out-of-hospital cardiac arrest(OHCA),while mechanical compression accounted for 55.1% in the in-hospital cardiac arrest (IHCA). 52.6% of the respondents who ever practised both CPR paterns considered mechanical compression as more effective than manual compression, a significantly higher percentage than those in the respondents who only practised manual compression or mechanical compression only (both P<0.001). The general percentage of conduction of manual compression during OHCA was 74.9%, significantly higher than that during IHCA (55.1%,P<0.001). And during OHCA, the percentage of the medical prefessionals who only practised manual compression was 76.9% among the non-emergency department staff members, not significantly different from that of the emergency department staff members(72.7%,P=0.78).During IHCA,the percentage of the medical professionals who only practised manual compression among those of non-emergency departments was 80.6%, significantly higher than that among those of emergency department (27.3%, P<0.001). There was no significant difference in expected CPR pattern among the medical professionals of emergency department and those of non-emergency department (P=0.06). The percentage of those who gave priority on mechanical compression among the medical professionals of emergency department was 57.6%, significantly higher than that among the medical professionals of non-emergency department(41.7%, P<0.05).Conclusion At present priority is still given to manual compression during CPR among the medical professionals, and the medical professionals of emergency department are inclined to replace manual compression by mechanical compression. It would be a trend to practise manual compression first and then to replace it when the mechanical press equipment is well prepared.
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