心肺复苏术护士复训最佳问隔时问的探讨

目的探讨临床护士进行心肺复苏术复训的最佳间隔时间。方法2001年1月～2002年1月对普通病区和高危科室的192名护士，随机分成四个组(A、B、C、D)，进行模拟培训后考核，然后间隔3、6、9、12个月实行跟踪考核，并在组间进行成绩及时间性的统计学比较。结果普通病区间隔3个月的成绩及时间性与培训后差异无显著意义，其他各组与间隔3个月的成绩相比较差异有显著意义；高危科室各组与3个月的考核成绩比较差异均无显著意义。结论普通病区护士应间隔3个月复训一次，既保证抢救质量，又能充分使用人力资源，为护理部、科室制定心肺复苏术的培训计划提供依据。     

心肺复苏术复训的最佳间隔时间

培训熟练的心肺复苏技术常用模型人进行模拟操练,时间过长则这种技术的熟练程度会逐渐减退。所以应该间隔一段时间进行复训。但间隔多长时间最佳,为此作者调查了教学医院非心血管病房的141名护士,按训练间隔时间分为3组。A组间隔时间为3个月,B组为6个月,C组为12个月。复训前每人均要求在模型人标本上进行2分钟复苏操     

急诊护士心肺复苏术培训的新进展

心肺复苏术是一项具有社会普遍价值的、在发病现场实用性很强的医疗急救技术。虽然已经在全社会进行推广培训,但现今在实际推广培训过程中存在很多不足,远未达到预期目标。本文就急诊护士培训内容和方法的新进展进行综述。     

两种临床护士心肺复苏术培训方法的效果比较

目的探讨适合临床护士的心肺复苏术培训模式。方法将100名临床护士分成实验组和对照组各50名,分别采用美国心脏协会培训模式和传统讲授练习模式进行心肺复苏术培训。并在培训结束时、培训结束3个月后对理论和技能进行考核。结果实验组护士的急救知识和技能操作考核通过率部分优于对照组护士(P<0.05)。培训结束3个月后进行复测,两组护士在理论和技能方面差异无统计学意义(P>0.05)。结论运用美国心脏协会培训模式,有利于临床护士掌握心肺复苏术理论及技能,适合在临床护士心肺复苏术培训中推广及应用,同时应定期对护士进行反复培训。     

思维导图定期复训对新护士心肺复苏技能的影响

目的 探讨思维导图定期复训对新护士心肺复苏技能的影响情况,为寻求高效的培训方式提供一定的参考和依据.方法 抽取本院2015年11月入职的新护士112人,随机分为思维导图组和常规培训组,分别在入职时、入职3个月及入职6个月进行心肺复苏的定期重复培训,培训后立即进行考核.思维导图组培训教师按思维导图分支分段示范2015版心肺复苏指南并讲解操作要点和相关理论知识,常规培训组采取先理论授课,后模拟操作方式培训.结果 思维导图组心肺复苏总分及主要操作步骤考核成绩整体均高于常规培训组,重复培训的3个时间点两组心肺复苏总分及主要操作步骤考核成绩差异均有统计学意义,思维导图组的CPR考核成绩上升幅度大于常规培训组,4个主要操作步骤得分情况两组不同时间点上升幅度的差异没有统计学意义.结论 思维导图是一个可靠和有效的工具,可用于新护士的CPR技能培训,复训的间隔周期以3个月为宜.     

个性化指导对培训急诊科新入院护士心肺复苏术的影响

目的：探讨个性化指导对培训急诊科新入院护士心肺复苏术（ Cardiopulmonary Resuscitation, CPR）的影响。方法选取本院2013年4月至2015年4月急诊科新入院的126名护士,将所有护士随机分为两组,每组63例。对照组使用传统的授课培训,观察组使用个性化指导培训。对比两组护士培训后对心肺复苏的掌握情况。结果考核后发现,观察组的理论和操作考核分数均较对照组高（ P＜0.05）;在操作过程中发现,观察组护士实际按压次数较对照组多,通气时间较对照组短（ P＜0.05）;培训结束后,观察组导师的满意度和护士的自我满意度均较对照组高（均P＜0.05）。结论个性化指导有利于护士认识自身的不足,更好地掌握CPR的操作。     

护士心肺复苏技能培训方法及复训时间的研究

心搏骤停是临床最危急的情况,立即进行心肺复苏(CPR)是抢救生命最关键的措施。临床护士与病人接触最密切,常是最先到达发生心搏骤停的现场者[1],因此护士必须掌握CPR技能。研究表明,重视护士CPR技能培训,尤其是CPR技能中的     

成人心肺复苏术的护理研究进展

对近年有关成人心肺复苏术中基础生命支持、高级生命支持、持续生命支持的进展及其护理进行综述。     

心肺复苏术147例的护理

对我院2001-10～2003-10由护士参与施行的心肺复苏(CPR)147例总结分析如下. 1临床资料 1.1一般资料本组男83例,女64例,年龄最大71岁,最小8岁,平均41.6岁.其中有机磷中毒42例,慢性阻塞性肺部疾病46例,脑血管意外25例,脑外伤8例,急性呼吸窘迫综合征9例,心源性肺水肿2例,心源性猝死15例.     

心肺复苏时血管加压素的应用研究

目的　研究血管加压素在心肺复苏中的疗效。方法　４８ 例心跳停搏患者随机分为４ 组,肾上腺素标准剂量组（ Ａ 组）１１ 例,肾上腺素大剂量组（ Ｂ组）１２ 例,血管加压素组（ Ｃ 组）１２ 例,肾上腺素＋ 血管加压素组（ Ｄ组）１３ 例,各组分别观察自主循环恢复率、存活率、自主循环恢复时间。结果　 Ａ 组、 Ｂ 组、 Ｃ 组、 Ｄ 组自主循环恢复率分别为１８２ ％ 、５８３ ％ 、２５ ％ 、６９２ ％ , Ｂ 组、 Ｄ 组明显高于 Ａ 组、 Ｃ 组; Ｄ 组存活率（４６２ ％ ） 显著高于 Ａ 组（９１ ％ ） 、 Ｂ 组（１６７ ％ ） 、 Ｃ 组（１６７ ％ ） ; Ｂ 组、 Ｄ 组的自主循环恢复时间明显短于其他两组。结论　心肺复苏期间,联合应用血管加压素和肾上腺素比单独应用血管加压素、肾上腺素能显著提高自主循环恢复率和存活率,缩短自主循环恢复时间。     

The effect of time since training on house officers' retention of cardiopulmonary resuscitation skills

Currently, the American Heart Association (AHA) recommends that physicians be certified in cardiopulmonary resuscitation (CPR) every two years. This study was undertaken to determine the effects of time since training on retention of CPR skills of physicians and to identify at what point performance deteriorates to a level requiring retraining with supervised practice. The physicians' performance of CPR one year or less after training was compared with that of more than one year after training. Thirty-three medical residents who had been taught CPR by the same instructor were tested without warning for one-person CPR on a recording mannikin. Performance was evaluated according to AHA Heartsaver criteria. The data were analyzed by organizing all CPR steps or behavioral objectives into three categories: assessment, skills (which included ventilation and compression), and sequence (which included calls for assistance). The data suggest that the knowledge of CPR sequence remains stable and that assessment improves while skill performance deteriorates after one year. This apparent contradiction in overall CPR performance may relate to the effect of experience. Assessment may improve because of involvement in actual resuscitations in the hospital. Deterioration of skills may reflect the fact that senior residents do not actually perform CPR, but become team leaders and thereby lose their skills, or that poor performance is not corrected in actual "code" situations. If a two-year certification standard is maintained, CPR skill testing at least every 12 months should be considered. If skills have deteriorated, hands-on-practice should be undertaken at that time.     

Intracranial pressure following cardiopulmonary resuscitation

Intracranial pressure (ICP) was measured in six patients following cardiopulmonary resuscitation (CPR). The causes of cardiac arrest were respiratory or circulatory problems and the primary intracranial pathology was not detected. The measurement of ICP started 3 to 10 h following CPR except one patient in whom it started on the day 7. Duration of ICP measurement ranged from 2 to 7 days. In five out of six patients, ICP persistently remained below 20 mmHg. In the remaining one patient, ICP elevation associated with seizure activity was observed and ICP ultimately increased to 57 mmHg. Among these, four patients died and two remained in a persistent vegetative state. These results suggest that ICP following CPR does not necessarily increase if the patient has no primary intracranial pathology or seizures.     

Coronary perfusion pressure during cardiopulmonary resuscitation

Currently, there is no way to measure the effectiveness of cardiopulmonary resuscitation in humans. The literature suggests that minimum aortic diastolic and estimated coronary perfusion pressures during cardiopulmonary resuscitation (CPR) in the animal model correlate with higher resuscitation rates. Six patients were studied during CPR to determine the arterial diastolic and estimated coronary perfusion pressures (arterial minus right atrial diastolic pressures). Mean arterial pressures were 27/11 mm Hg, central venous pressures were 32/10 mm Hg, and the mean estimated coronary perfusion pressure was only 1 mm Hg. None of the six patients survived. This study demonstrates that the techniques of measuring hemodynamic values during CPR is practical. Poor estimated coronary perfusion pressures were obtained from the six patients studied. This study should be extended to include a large number of patients to determine whether these hemodynamic parameters can be used as prognostic indicators of successful resuscitation in humans.     

昼夜不同时间心肺复苏的临床研究

目的:探讨昼夜不同时间心肺复苏(CPR)成功率的差异。方法:对2005年1月-2008年12月在我院急诊内科进行CPR的86例患者进行回顾性分析。结果:CPR白天成功率30.8%,夜间成功率8.8%,两者比较有统计学意义(P0.05)。结论:及时发现、尽早规范是CPR成功的关键。     

肾上腺素联合甲氧明在心肺复苏中的应用研究

目的 通过窒息法制备家兔心搏骤停模型,探索肾上腺素联合甲氧明在心肺复苏过程中的应用.方法 将27只家兔随机(随机数字法)分为甲氧明组、肾上腺素组、联合用药组,每组9只.建立窒息型家兔心搏骤停模型后,复苏时三组家兔分别予甲氧明、肾上腺素、联合用药.记录家兔窒息前与复苏成功后15、30、60、120 min各时间点的心率、平均动脉压和心电图的变化;比较实验各组家兔自主循环恢复率和2h存活率.复苏成功后2h取心肌组织进行光镜及电镜检查.结果 甲氧明组、肾上腺素组、联合用药组三组分别有1只、6只、5只家兔复苏成功.自主循环恢复后家兔心率及平均动脉压值均较窒息前有明显下降(P＜0.05);复苏成功后15 min、30 min联合用药组的平均动脉压较肾上腺素组高,差异有统计学意义(P＜0.05).心肌组织HE染色光镜及电镜观察显示复苏后心肌组织出现明显的病理改变,且心肌损伤程度在联合用药组较轻.结论 复苏时肾上腺素与甲氧明联合应用对自主循环恢复率并无提升作用,但对复苏成功后早期血流动力学稳定有帮助作用;复苏时肾上腺素与甲氧明联合应用对复苏后心肌有一定的保护作用.     

2005国际心肺复苏和心血管急救指南解读

2005年国际复苏联盟（ILCOR）和美国心脏协会（AHA）重新修订了心肺复苏（CPR）及心血管急救（ECC）的推荐方案。目的使指南更适用于全球范围。现对指南主要的变化、基本生命支持重要的内容、进一步生命支持的主要变化作一介绍。     

心肺复苏循环复后淀粉酶改变与预后关系的研究

目的探讨心肺复苏期间血清淀粉酶变化的预后意义。方法对42例进行心肺复苏并一度建立自主循环的心跳骤停患者的血清淀粉酶、血气分析指标和24h生存率进行观察。结果①血清淀粉酶＞400U/L组的24h生存率(16.7％)明显低于＜400U/L组(70.8％,P=0.00055);②血清淀粉酶逐渐增高组的死亡率高于逐渐降低组(P=0.05450);③24h生存组的血清淀粉酶水平为431.3±229.5U/L,低于死亡组(559.0±254.9U/L),2组比较差异接近显著(t=1.865,P＜0.1);④血清淀粉酶＞400U/L组的pH值为7.014±0.228,明显低于＜400U/L组(pH7.137±0.165),差异显著(t=2.031,P＜0.05)。结论心肺复苏期间血清淀粉酶升高,尤其是逐渐增高者,提示预后不良。     

Web-based video and feedback in the teaching of cardiopulmonary resuscitation

Knowledge and skills relating to cardiopulmonary resuscitation tend to be lost over time. The combination of simulation sessions with online video records and online feedback allows for an enduring record of skills sessions to assist students in retaining and revising their learning. This paper reports a qualitative evaluation of such a combination used in inter-disciplinary sessions for volunteer nursing and medical students. Methods included focus groups and free text questionnaires; data were gathered from fourteen students and three teachers. Students had used the online material in a variety of personal ways, and found that the addition to their learning was significant. Their memories of the simulation sessions and of the feedback received immediately afterwards were incomplete, and repeated viewing enabled them to identify good and poor practice with more confidence, and to reflect more carefully on their own and others' practice. Teachers found it easier to give more detailed feedback when given the chance to watch the video than immediately after the session. All felt that the sessions would ideally be embedded in the curriculum.     

心肺复苏后大鼠肝细胞凋亡的实验研究

目的研究心肺复苏后大鼠肝细胞的凋亡情况及其可能机制。方法sD雄性大鼠40只，随机分为5组，即对照组（假手术组）以及复苏后3、6、12、24h组，每组各8只。采用窒息合并冰氯化钾停跳液致大鼠心跳骤停-心肺复苏模型，停跳5min后开始心肺复苏，采用TUNEL法观察复苏后肝细胞的凋亡情况，采用免疫组化的方法观察大鼠肝细胞Bcl-2、fas基因的表达情况。结果复苏后3h大鼠肝细胞就有明显凋亡，复苏后6h达到高峰（P〈0．01），24h肝细胞TUNEL仍为高表达；复苏后3h肝细胞Bcl-2有微弱表达，6h表达增加，24h达到高峰；而fas复苏后3h即呈高表达，与对照组比较差异有统计学意义（P〈0．01），之后持续高表达。结论心肺复苏后大鼠存在肝细胞凋亡．其中fas的高表达介导了肝细胞凋亡。