湖北省急救技能竞赛医生心肺复苏术操作技能分析

Analysis on emergency CPR operation skills of doctors in first aid skill competition in Hubei

目的分析2016年湖北省急诊医生在省级急救技能竞赛中心肺复苏(CPR)站点操作评分,为提高我省急诊医生救助能力策略的制定提供依据。方法分析18组参赛队伍医生CPR操作技能失分情况。结果CPR应急反应能力评分:1两组(66.67%)在10 s内完成脉搏呼吸判断;8组(44.44%)反应时间超过30 s;开始除颤时间延迟,仅4组(22.22%)得分。QCPR实时反馈系统记录如下:15组(83.3%)按压位置正确率为100%;9组(50.0%)胸外按压分数在60%~89%之间;4组(22.2%)完全胸壁回弹率大于90%;按压深度、按压频率的得分大于90%人数较少,仅1组(5.6%)、两组(11.1%);16组(88.89%)按压间停时间有超过10 s的记录;13组(72.2%)通气得分率小于60%。各竞赛项目评分,“初次自动体外除颤器操作”为扣分最多的项目,失分率77.78%(14/18);单人CPR操作错误率均高于第一轮双人CPR;第二轮双人CPR错误率显著低于第一轮;第三轮双人CPR错误率显著高于第二轮。结论湖北省医生整体CPR操作水平较高,但仍需在细节上加强练习,以达到《2015年美国心脏协会心肺复苏及心血管急救指南》(简称《指南》)建议标准。

Objective To analysze the cardiopulmonary resuscitation(CPR)performance of Hubei emergency medical doctors in 2016 first-aid skill competition,to provide evidence for improving the first-aid ability of emergency medical staff.Methods CPR scores for each team were reviewed and analyzed,and the loss of operating skills were analyzed.Results CPR emergency response ability score:12(66.67%)completed pulse and respiration judgment within 10 s.Only 1(5.6%)completed the immediate reaction within 16 seconds and 8(44.44%)had a reaction time of more than 30 seconds.The time of defibrillation initiation was delayed,and only 4(22.22%)got scores.In QCPR real-time feedback system index:The correct rate of pressing position was 100%in group 15(83.3%).Chest compressions fraction(CCF)ranged from 60%to 89%in 9 groups(50.0%).In 4 groups(22.2%),the full chest wall recoil l was more than 90%.There were only 1 group(5.6%)and 2 groups(11.1%)with the score of pressing depth and frequency greater than 90%.16(88.89%)had more than 10s of press interruption time.The ventilation score of group 13(72.2%)was less than 60%."The first automatic external defibrillator(AED)operation"was the item with the most points deducted,with 77.78%(14/18)of the total points lost.The error rate of each single CPR operation was higher than the first two-person CPR.The error rate of two-person CPR in the second round was significantly lower than the first round.The error rate of two-person CPR in round 3 was significantly higher than round 2.Conclusion Doctors in Hubei province generally have a high level of CPR operation,but they still need to strengthen practice detailedly to meet the recommended standards in the Guidelines.