摘要
目的：了解急诊医护人员实施单人徒手胸外心脏按压的质量,并分析影响因素。方法采用便利抽样法选取急诊科医护人员120名,按照2010美国心脏协会心肺复苏及心血管急救指南（简称2010版新指南）对胸外心脏按压质量的要求,在复苏模拟人身上实施单人徒手胸外心脏按压2 min,电脑自动记录按压质量数据,包括按压频率、按压深度、胸壁回弹率等测试结果。结果120名医护人员中,胸外心脏按压定位准确91人,准确率为75.8%；按压姿势准确80人,准确率为66.7%；平均按压频率为（131.1±14.3）次/min；0~30 s按压深度为（5.4±0.5）cm,31~60 s按压深度为（5.2±0.5）cm,61~90 s按压深度为（4.9±0.4）cm,91~120 s按压深度为（4.7±0.5）cm；胸壁回弹率为（66.9±29.2）%；胸外心脏按压质量指标男性按压者在按压频率控制上优于女性,按压深度高于女性,差异有统计学意义（P〈0.01）；胸壁回弹率上差异无统计学意义（P〉0.05）。在第3及第4个按压时段（即持续按压1 min后）不同职称和工作年限的按压者存在差异,中级职称以上按压深度高于初级职称,工作年限较长者按压深度较高,差异有统计学意义（P〈0.05）。其他质量指标在不同年龄、工作年限、职称及学历之间差异无统计学意义（P〉0.05）。结论急诊医护人员胸外心脏按压质量还不能满足2010版新指南的要求,应该着重培训按压频率的控制来保证足够的按压深度和胸壁回弹率,并在按压过程中保持按压姿势的准确,尤其是对于女性按压者,可以通过减少持续按压的时间来保证按压质量。
Objective To investigate the quality of emergency medical staffs to understand single hand cardiac compression, and analyze factors influenced the quality of cardiac compression. Methods A convenience sample of 120 medical staffs in the Emergency Department of PUMCH had been selected according to the compression′s quality requirement of AHA 2010 guidelines, that compressed heart 2 min by single hand and the computer would recorded the data automatically including pressing rate, pressing depth, chest wall recoil, etc. Results A total of 120 doctors and nurses accuracy rate of chest compression positioning was 75. 8% （91/120）;the accuracy rate of pressing depth was 66. 7%;the average compression rate was （131. 1 ＆#177; 14. 3） beats/min;press depth was （5. 4 ＆#177; 0. 5） cm in 0-30 s, press depth （5. 2 ＆#177; 0. 5） cm in 31-60 s, press depth （4. 9 ＆#177; 0. 4cm）, pressing depth （4. 7 ＆#177; 0. 5） cm cm in 61-90s and 91-120s ; rebound rate of chest wall was （66. 9 ＆#177; 29. 2）%. Chest compression quality indexes impacted by different gender, of which the male did better than the women in press frequency control, and they had statistical significant （P〈0. 05） and the pressing depth in the press time, but rebound of chest wall had no statistical difference （P〉0. 05）. Therewere significant differences for working years and professional title in the third and fourth stage of pressing time, that medical staffs with intermediate title or above press more deep than the primary title, staffs with long working experiences press deeper. No statistically significant difference had been found in other quality index such as different ages, working years, and professional title. Conclusions The chest compressions quality of emergency medical staffs still can not meet the requirement of 2010 new guidelines, so we should focus on training on the press frequency controlling, to guarantee the pressing depth and chest wall resilience sufficient rate, keep the press position accurately, especially for women, and we can reduce the continue compression time to guarantee the pressing quality.
出处
《中华现代护理杂志》
2015年第12期1393-1397,共5页
Chinese Journal of Modern Nursing
关键词
急诊室
医院
医护人员
胸外心脏按压
质量
Emergency department, Hospital
Medical staffs
Chest compression
Quality
作者简介
通信作者：绳宇，Email：shengyumm@126．com
