院外心搏骤停患者的家庭救护最佳证据分析

Best evidence summary for family first aid of patients after out-of hospital cardiac arrest

目的 检索并汇总国内外院外心搏骤停患者的家庭救护相关证据,为制订科学合理的家庭救护方案提供实践依据。方法 按照“6S”证据模型自上而下的原则,系统检索国内外指南网、专业协会网、循证数据库、综合数据库中关于院外心搏骤停患者家庭救护的证据,包括临床决策、指南、证据总结、专家共识、系统评价、Meta分析等,检索时限为自建库至2023年4月30日。由2名经循证方法培训的护理研究生对文献质量进行评价,选取符合纳入标准的文献,并提取证据。结果 共纳入19篇文献,包括临床决策3篇、指南7篇、专家共识5篇、系统评价4篇。总结出32条证据,包括识别、启动急救医疗服务、胸外按压、开放气道、人工呼吸、除颤、移动互联网技术支持、教育培训8个方面。结论 科学、系统的总结了院外心搏骤停患者家庭救护的最佳证据,为发生院外心搏骤停时第一目击者实施家庭救护措施提供循证依据。

Objective To retrieve and summarize evidence related to family first aid for patients with out-of-hospital cardiac arrest both domestically and internationally,and to provide practical basis for developing scientific and reasonable family first aid plans.Methods According to the top-down principle of the"6S"evidence model,the the domestic and foreign guide websites,professional association websites,evidence-based databases,and comprehensive databases for evidence related to home care for patients with cardiac arrest outside the hospital were researched,including clinical decision-making,guidelines,evidence summary,expert consensus,system evaluation,and meta analyse.The search period was from the establishment of the database to April 30,2023.Two researchers trained in evidence-based methods evaluated the quality of the literature,selected literature that met the inclusion criteria,and extracted evidence.Results A total of 19 articles were included,including 3 clinical decision-making articles,7 guidelines,5 expert consensus articles,and 4 systematic evaluations.Summarize 32 pieces of evidence,including 8 aspects:identification,initiation of emergency medical services,chest compressions,open airway,artificial respiration,defibrillation,mobile internet technology support,and education and training.Conclusion The best evidence for family first aid for patients with out-of-hospital cardiac arrest is obtained through scientific and systematic summary,providing evidence-based evidence for the first witness to implement family first aid measures during cardiac arrest outside the hospital.