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The general public’s ability to operate automated external defi brillator: A controlled simulation study

World Journal of Emergency Medicine 2020年第4期11卷 238-245页

作者： Xue-jie Dong Lin Zhang Yue-lin Yu Shu-xiao Shi Xiao-chen Yang Xiao-qian Zhang Shuang Tian Helge Myklebust Guo-hong Li Zhi-jie Zheng School of Public Health Shanghai Jiao Tong UniversityShanghaiChina School of Medicine Shanghai Jiao Tong UniversityShanghaiChina laerdal medical StavangerNorway School of Public Health Peking UniversityBeijingChina

BACKGROUND:Automated external defibrillators(AEDs)enable laypeople to provide early defi brillations to patients undergoing cardiac arrest,but scant information is available on the general public’s ability to use *** study assessed the ability of laypeople to operate AEDs,the effect of a 15-minute training,and whether skills differed by ***:From May 1 to December 31,2018,a prospective simulation study was conducted with 94 laypeople aged 18–65 years(32 aged 18–24 years,34 aged 25–54 years,and 28 aged 55–65 years)with no prior AED *** participants’AED skills were assessed individually pretraining,post-training,and at a three-month follow-up using a simulated cardiac arrest *** critical actions and time intervals were evaluated during the AED operating ***:Only 14(14.9%)participants(eight aged 18–24 years,four aged 25–54 years,and two aged 55–65 years)successfully delivered defi brillations before *** operation errors were more likely to occur among the participants aged 55–65 years than among other age *** training,the proportion of successful defi brillations increased signifi cantly(18–24 years old:25.0%vs.71.9%,P<0.01;25–54 years old:11.8%vs.70.6%,P<0.01;55–65 years old:7.1%vs.67.9%,P<0.01).After three months,26.1%of the participants aged 55–65 years successfully delivered defi brillations,which was signifi cantly lower than that of participants aged 18–24 years(54.8%)and 25–54 years(64.3%)(P=0.02).There were no differences in time measures among three age groups in each ***:The majority of untrained laypeople cannot effectively operate *** frequent training and refresher courses are crucial to improve AED skills.

关键词： Automated external defi brillator Cardiac arrest General public Training Simulation

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医院内心脏骤停的心肺复苏质量

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美国医学会杂志（中文版） 2006年第1期25卷 17-21页

作者： Bonjamin S. Abella Jason P. Alvarado Helge Myklebust, Beng Dana P. Edelson Anne Barry, RN, MBA Nicholas O＇ Hearn, RN, MSN Terry L Vanden Hoek Lance B. Becker 方跃华（译）沈卫峰（校） Sections of Emergency Medicine Sections of Emergency Medicine and Critical Care University of Chicago Hospitals Chicago lll and laerdal medical Corporation Stavangerl Norway 不详

背景：正确进行心肺复苏（cardiopulmory resuscitation，CPR）能提高存活率已被公认，但尚缺乏心脏骤停时实际CPR质量的客观资料。最近的研究已对按照现行国际指南统一实施CPR这一观念提出了挑战。目的：测定院内CPR质量的多个参数，... 详细信息

背景：正确进行心肺复苏（cardiopulmory resuscitation，CPR）能提高存活率已被公认，但尚缺乏心脏骤停时实际CPR质量的客观资料。最近的研究已对按照现行国际指南统一实施CPR这一观念提出了挑战。目的：测定院内CPR质量的多个参数，确定临床对美国心脏病协会和国际指南的依从性。设计和对象：对2002年12月11日至2004年4月5日芝加哥大学医院内发生的67例心脏骤停患者进行前瞻性观察研究。使用一种新的附加感应功能的监护／除颤仪，记录的CPR质量参数包括胸外按压频率、按压深度、通气频率和无胸外按压的停搏时间段（无血流分数）。主要观察指标：对美国心脏病协会和国际CPR指南的坚持程度。结果：按照30秒时段对每例复苏最初5分钟进行分析发现，在28．1％的时段胸外按压频率低于90次／min。37．4％按压深度过浅（〈38mm）。通气频率较高，60．9％的时段频率超过20次／min。此外，平均（sD）无血流分数为0．24（0．18）。心脏骤停时每分钟有10秒钟的停顿将产生0．17的无血流分数。总共27例（40．3％）成功恢复自主循环，并有7例（10．4％）出院。结论：在本医院内心脏骤停研究，即使CPR由曾受良好训练的医务人员实施，CPR多项参数的质量亦不一致，而且常常与指南的建议不符。高质量CPR的重要性提示，在实施复苏期间需要救护人员的反馈和监测CPR质量。

关键词：质量参数心脏骤停心肺复苏医院内 resuscitation 美国心脏病协会国际指南按压频率胸外按压 CPR

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苏州市急救医护人员心脏急救培训效果及分析

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中国急救复苏与灾害医学杂志 2019年第6期14卷 512-516页

作者：潘纯王亮杨齐英周振祥 Tonje Soraas Birkenes HeIge Myklebust 吴智鑫罗曚悦张琳郑志杰苏州市急救中心苏州215031 laerdal medical Stavanger Norway 广州中医药大学附属佛山中医院上海交通大学公共卫生学院北京大学公共卫生学院

目的为响应苏州市“531”政策,切实提高苏州地区医护人员急救素养和能力,开展中国心肺复苏联盟心肺复苏培训学院苏州站年度培训班.通过理论和实操结合培训模式,加强医务人员的心脏急救能力。方法于2017年5月13-14日,针对苏州地区院外急... 详细信息

目的为响应苏州市“531”政策,切实提高苏州地区医护人员急救素养和能力,开展中国心肺复苏联盟心肺复苏培训学院苏州站年度培训班.通过理论和实操结合培训模式,加强医务人员的心脏急救能力。方法于2017年5月13-14日,针对苏州地区院外急救医务人员及院内急诊科医务人员进行心脏急救相关理论(8学时)及实践操作培训(4学时)。理论培训采用美国亚利桑那州CPR培训的标准化教学视频配美国专业导师授课讲解,实践操作釆用心肺复苏实施反馈系统(QCPRclassroom,挪度医疗)监测学员按压深度、按压频率、间隔时间等实操能力。并在培训前后对学员进行笔试测评,考核学员心脏急救理论能力。结果2017年心肺复苏培训学院苏州站共有98名学员参加,83名签署知情同意书、成绩完整有效的学员成绩纳入分析。通过培训,学员心肺复苏操作技能成绩显著提高:培训前57.00(24.25~82.50)分vs培训后96.00(82.75-99)分,PvO.001,其中,按压充分回弹是心肺复苏操作环节中,医务人员容易忽视的要点,通过实操培训,按压回弹正确率显著提高,培训前17.16%(2.32%~47.12%)vs培训后89.90%(43.35%-100%),P<0.001.此外,学员心脏急救基础生命支持和高级生命支持理论关键问题正确率为:培训前(10.05±1.30)题,培训后为(10.67±1.39)题,P<0.05。结论中国心肺复苏联盟心肺复苏培训学院制定的年度培训机制和国际化培训方案,有助于提高医护人员心脏急救能力素养。通过培训,可切实加深医护人员对基础生命支持和高级生命支持的理论知识理解,并通过大规模反馈模拟系统,可较快提升医护人员实际操作水平。

关键词：心肺复苏培训医护人员反馈模拟系统

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Correlations between quality indexes of chest compression

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World Journal of Emergency Medicine 2013年第1期4卷 54-58页

作者： Feng-ling Zhang Li Yan Su-fang Huang Xiang-jun Bai Department of Emergency Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology

BACKGROUND:Cardiopulmonary resuscitation(CPR) is a kind of emergency treatment for cardiopulmonary arrest,and chest compression is the most important and necessary part of *** American Heart Association published the new Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care in 2010 and demanded for better performance of chest compression practice,especially in compression depth and *** current study was to explore the relationship of quality indexes of chest compression and to identify the key points in chest compression training and ***:Totally 219 healthcare workers accepted chest compression training by using laerdal ACLS advanced life support resuscitation *** quality indexes of chest compression,including compression hands placement,compression rate,compression depth,and chest wall recoil as well as self-reported fatigue time were monitored by the laerdal Computer Skills and Reporting ***:The quality of chest compression was related to the gender of the *** indexes in males,including self-reported fatigue time,the accuracy of compression depth and the compression rate,the accuracy of compression rate,were higher than those in ***,the accuracy of chest recoil was higher in females than in *** quality indexes of chest compression were correlated with each *** self-reported fatigue time was related to all the indexes except the compression ***:It is necessary to offer CPR training courses *** clinical practice,it might be better to change the practitioner before fatigue,especially for females or weak *** training projects,more attention should be paid to the control of compression rate,in order to delay the fatigue,guarantee enough compression depth and improve the quality of chest compression.

关键词： Cardiopulmonary resuscitation Chest compression Quality indexes Correlation

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Effect of a low-cost instruction card for automated external defibrillator operation in lay rescuers: a randomized simulation study

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World Journal of Emergency Medicine 2023年第4期14卷 265-272页

作者： Qiang Zhou Xuejie Dong Wei Zhang Rengyu Wu Kaizhu Chen Hongjuan Zhang Zhijie Zheng Lin Zhang Shenzhen Emergency medical Center Shenzhen 518035China Department of Global Health School of Public HealthPeking UniversityBeijing 100083China Shanghai Jiao Tong University School of Medicine Shanghai 200025China School of Public Health Shanghai Jiao Tong UniversityShanghai 200025China School of Nursing Shanghai Jiao Tong UniversityShanghai 200025China

BACKGROUND:To evaluate whether a simplified self-instruction card can help potential rescue providers use automated external defibrillators(AEDs)more accurately and ***:From June 1,2018,to November 30,2019,a prospective longitudinal randomized controlled simulation study was conducted among 165 laypeople(18–65 years old)without prior AED training.A self-instruction card was designed to illuminate key AED operation *** were randomly divided into the card(n=83)and control(n=82)groups with age *** were then individually evaluated in the same simulated scenario to use AED with(card group)or without the self-instruction card(control group)at baseline,posttraining,and at the 3-month ***:At baseline,the card group reached a significantly higher proportion of successful defibrillation(31.1%vs.15.9%,P=0.03),fully baring the chest(88.9%vs.63.4%,P<0.001),correct electrode placement(32.5%vs.17.1%,P=0.03),and resuming cardiopulmonary resuscitation(CPR)(72.3%vs.9.8%,P<0.001).At post-training and follow-up,there were no significant differences in key behaviors,except for resuming *** to shock and time to resume CPR were shorter in the card group,while time to power-on AED was not different in each phase of *** the 55–65 years group,the card group achieved more skill improvements over the control group compared to the other age ***:The self-instruction card could serve as a direction for first-time AED users and as a reminder for trained *** could be a practical,cost-effective way to improve the AED skills of potential rescue providers among different age groups,including seniors.

关键词： Automated external defibrillator Laypeople Skill Instruction card Simulation

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Observing the stages of bystander intervention in virtual reality simulation

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World Journal of Emergency Medicine 2019年第3期10卷 145-151页

作者： David G. Buckler Alfredo Almodovar Jr Paul Snobelen Benjamin S. Abella Audrey Blewer Marion Leary Center for Resuscitation Science University of Pennsylvania Philadelphia PA 19104 USA Peel Regional Paramedic Service 1600 Bovaird Dr. E Brampton ON L6R 3S8 Canada Department of Community & Family Medicine Duke University Medical Center DUMC 2914 Durham NC 27710 USA School of Nursing University of Pennsylvania 418 Guardian Drive Philadelphia PA 19104 USA

BACKGROUND: Understanding bystander reactions to an emergency is an important component of effective training. Four stages of bystander intervention (BI) have been previously described: noticing the situation as a problem, interpreting when it is appropriate to intervene, recognizing personal responsibility to intervene, and knowing how to intervene. Using virtual reality (VR) to simulate emergencies such as sudden cardiac arrest (SCA) can be used to study these stages. METHODS: In a secondary analysis of an observational cohort study, we analyzed bystander self-effi cacy for stages of BI before and after simulated SCA. Each subject participated in a singleplayer, immersive, VR SCA scenario. Subjects interacted with simulated bystanders through voice commands (“call 911”,“get an AED”). Actions taken in scenario, like performing CPR, were documented. Scenario BI actions were compared based on dichotomized comfort/discomfort. RESULTS: From June 2016 to June 2017, 119 subjects participated. Average age was 37±14 years, 44% were female and 46% reported CPR training within 2 years. During the scenario, 98%“noticed the event” and “interpreted it as a problem”, 78%“took responsibility”, and 54%“possessed the necessary skills”. Self-effi cacy increased from pre- to post-scenario: noticing the event increased from 80% to 96%;interpreting as a problem increased from 86% to 97%;taking responsibility increased from 56% to 93%;possessing necessary skills increased from 47% to 63%(P<0.001). CONCLUSION: Self-efficacy to respond to an SCA event increased pre- to post-scenario. Bystanders who reported feeling comfortable “taking responsibility to intervene” during an emergency were more likely to take action during a simulated emergency.

关键词： Virtual reality Bystander intervention Emergency preparedness

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Minocycline fails to improve neurologic and histologic outcome after ventricular fibrillation cardiac arrest in rats

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World Journal of Critical Care Medicine 2019年第7期8卷 106-119页

作者： Andreas Janata Ingrid AM Magnet Kristin L Schreiber Caleb D Wilson Jason P Stezoski Keri Janesko-Feldman Patrick M Kochanek Tomas Drabek Safar Center for Resuscitation Research University of Pittsburgh School of MedicinePittsburghPA 15224United States Department of Critical Care Medicine University of Pittsburgh School of MedicinePittsburghPA 15213United States Emergency Department KA RudolfstiftungVienna 1030Austria Department of Emergency Medicine Vienna General HospitalMedical University of ViennaVienna 1090Austria Department of Anesthesiology and Perioperative Medicine University of Pittsburgh School of MedicinePittsburghPA 15213United States Department of Anesthesiology Perioperative and Pain MedicineBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115United States Wyoming Otolaryngology Wyoming Medical CenterCasperWY 82604United States

BACKGROUND Prolonged cardiac arrest(CA)produces extensive neuronal death and microglial proliferation and activation resulting in neuro-cognitive *** other potential mechanisms,microglia have been implicated as triggers of neuronal death after hypoxic-ischemic *** is neuroprotective in some brain ischemia models,either by blunting the microglial response or by a direct effect on *** To improve survival,attenuate neurologic deficits,neuroinflammation,and histological damage after ventricular fibrillation(VF)CA in *** Adult male isoflurane-anesthetized rats were subjected to 6 min VF CA followed by 2 min resuscitation including chest compression,epinephrine,bicarbonate,and *** return of spontaneous circulation(ROSC),rats were randomized to two groups:(1)Minocycline 90 mg/kg intraperitoneally(i.p.)at 15 min ROSC,followed by 22.5 mg/kg *** 12 h for 72 h;and(2)Controls,receiving the same volume of vehicle(phosphate-buffered saline).The rats were kept normothermic during the postoperative *** injury was assessed daily using Overall Performance Category(OPC;1=normal,5=dead)and Neurologic Deficit Score(NDS;0%=normal,100%=dead).Rats were sacrificed at 72 *** degeneration(Fluoro-Jade C staining)and microglia proliferation(anti-Iba-1 staining)were quantified in four selectively vulnerable brain regions(hippocampus,striatum,cerebellum,cortex)by three independent reviewers masked to the group *** In the minocycline group,8 out of 14 rats survived to 72 h compared to 8 out of 19 rats in the control group(P=0.46).The degree of neurologic deficit at 72 h[median,(interquartile range)]was not different between survivors in minocycline vs controls:OPC 1.5(1-2.75)vs 2(1.25-3),P=0.442;NDS 12(2-20)vs 17(7-51),P=0.328)or between all studied *** number of degenerating neurons(minocycline vs controls,mean±SEM:Hippocampus 58±8 vs 76±8;striatum 121±43 vs 153±32;cerebellum 20±7 vs 22

关键词： Heart arrest/pathology Cardiopulmonary resuscitation Survival rate Neurons/drug effects Microglia/drug effects Minocycline/pharmacology

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