A Survey on the Perception of Utstein Model and the Success of Resuscitation among the Chinese Medical Staffs
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摘要:
目的 调查我国医护人员对乌斯坦因模式(Utstein model)的知晓情况及对复苏成功的评判标准。 方法 采用问卷调查的方式,对中国大陆医护人员进行随机抽样调查。 结果 仅有58.8%的参与者知晓乌斯坦因模式,知晓率与所在科室是否登记复苏结果关系最大,护士、男性、年轻人(< 40岁)、高级职称和高学历者、在心脏急症相关科室工作者知晓率更高,但是高级别医院组的知晓率低于低级别医院组,近期(< 6月)接受CPR培训组知晓率低于长时间(> 2 a)未接受CPR培训组。84.5%的参与者认为除颤后存活是复苏成功的标准。认为判断指标持续时间大于30 s、大于20 min和大于24 h才可判定为复苏成功的参与者分别有24.9%、33.4%和18.4%。 结论 我国医护人员对乌斯坦因模式知晓率低,对“复苏成功”概念的理解混乱,需加强乌斯坦因登记模式的普及和推广。 Abstract:Objective To investigate the knowledge of the Utstein model and the criteria for evaluating the success of resuscitation among Chinese medical staffs. Method A random sampling survey was conducted among the medical staffs in Mainland of China. Results Only 58.8% of the participants had heard of the Utstein model. The awareness rate of the Utstein model was mostly related to whether the participant works in a department where registered the results of resuscitation, nurses, males, young people, senior professional titles and highly educated individuals, staff works in cardiac emergency-related department had a higher awareness rate of Utstein model. However, the awareness rate of high level hospital group was lower than that of the low level hospital group, the group who received a training within 6 months did not have a higher awareness rate than the group who had no training more than 2 years. 84.5% of participants considered that post-defibrillation survival was a standard for successful resuscitation. Additionally, 24.9%, 33.4%, and 18.4% of participants believed that judgment indicators lasted more than 30 seconds, more than 20 minutes, or more than 24 hours indicated successful resuscitation, respectively. Conclusions The awareness rate of Utsteinmodel among the medical staff is low, and the understanding of the term “success of resuscitation” is very confusing in China. It is urgent to strengthen the popularization and application of the Utstein registration model. -
Key words:
- Utstein model /
- Medical staff /
- Cardio-pulmonary resuscitation /
- Successful resuscitation
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表 1 参与者对Utstein模式的知晓情况[n(%)]
Table 1. Participants' knowledge of Utstein model[n(%)]
项目 总数 Utstein模式的知晓情况 知晓 不知晓 Z P 性别 男 4126(40.4) 2554(61.9) 1572(38.1) 5.316 < 0.001 * 女 6098(59.6) 3453(56.6) 2645(43.4) 职业 医生 5829(57.0) 3255(55.8) 2574(44.2) 6.889 < 0.001 * 护士 4395(43.0) 2752(62.6) 1643(37.4) 年龄 < 29岁 5147(50.3) 3269(63.5) 1878(36.5) < 0.001 * 30-39岁 3778(37.0) 2188(57.9) 1590(42.1) 5.417 > 40岁 1299(12.7) 550(42.3) 749(57.7) 职称 初级职称 4116(40.3) 1898(46.1) 2218(53.9) 6.897 < 0.001 * 中级职称 4033(39.4) 2624(65.0) 1412(35.0) 高级职称 2075(20.3) 1488(71.7) 587(28.3) 学历 专科及以下 2299(22.5) 1256(54.6) 1043(45.4) < 0.001 * 本科 5891(57.6) 3406(57.8) 2485(42.2) 5.972 硕士及以上 2034(19.9) 1345(66.1) 689(33.9) 医院级别 急救中心# 1046(10.2) 813(77.7) 233(22.3) < 0.001 * 一级医院 3125(30.6) 2156(69.0) 969(31.0) 6.089 二级医院 3043(29.8) 1708(56.1) 1335(43.9) 三级医院 3010(29.4) 1330(44.2) 1680(55.8) 科室 院前急救# 1052(10.3) 825(78.4) 227(21.6) < 0.001 * 急诊科 2217(21.7) 1459(65.8) 758(34.2) ICU 881(8.6) 555(63.0) 326(37.0) 麻醉科 507(5.0) 311(61.3) 196(38.7) 7.785 心脏内外科 735(7.2) 471(64.1) 264(35.9) 妇产儿科 1265(12.4) 817(64.6) 448(35.4) 其他科室 3567(34.9) 1569(44) 1998(56) 培训时间 < 6 月 4366(42.7) 2215(50.7) 2151(49.3) 6.962 < 0.001 * 6月~2a 3368(32.9) 2174(64.5) 1194(35.5) > 2a 2111(20.6) 1491(70.6) 620(29.4) 从未培训过 379(3.7) 127(33.5) 252(66.5) 科室登记复苏结果 是 7380(72.2) 5417(73.4) 1963(26.6) 7.097 < 0.001 * 否 2844(27.8) 590(20.7) 2254(79.3) *P < 0.05. #有的急救中心有住院病床,而有的急救医生为院内各科室医生轮班,导致医院和科室的数据有差别。 表 2 Utstein模式知晓率的多因素Logistic回归分析
Table 2. Multivariate Logistic regression analysis of Utstein model awareness rate
项目 P OR 95%CI 职业 护士 1 医生 < 0.001 0.616 0.545~0.696 性别 女性 1 男性 < 0.001 1.443 1.282~1.624 年龄 < 29岁 1 30-39岁 < 0.001 0.652 0.582~0.732 > 40岁 < 0.001 0.313 0.265~0.369 职称 初级职称 1 中级职称 < 0.001 2.361 2.095~2.661 高级职称 < 0.001 3.475 2.973~4.063 学历 专科及以下 1 本科 0.429 1.052 0.927~1.194 硕士及以上 < 0.001 1.473 1.242~1.747 医院级别 一级医院 1 二级医院 < 0.001 0.539 0.473~0.613 三级医院 < 0.001 0.366 0.321~0.417 急救中心 0.802 1.027 0.834~1.264 科室 其他科室 1 院前急救 < 0.001 2.113 1.717~2.601 急诊科 < 0.001 1.424 1.244~1.630 ICU 0.015 1.258 1.045~1.515 麻醉科 0.040 1.272 1.011~1.600 心内科 < 0.001 1.498 1.229~1.827 妇产儿科 < 0.001 1.869 1.589~2.198 近期培训 > 2a 1 6月-2 a 0.108 0.889 0.769~1.026 < 6月 < 0.001 0.512 0.445~0.588 从未培训 < 0.001 0.376 0.283~0.499 科室登记复苏结果 否 1 是 < 0.001 8.611 7.684~9.650 -
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