护士心肺复苏操作现况及培训效果的评价

目的评价泰安地区3家三甲医院护士进行心肺复苏培训的实际效果。方法应用心肺复苏培训设备对每个人员进行模拟心肺复苏操作,检测复苏时按压幅度、按压频率、按压问释放压力,同时记录5组30：2CPR操作按压及通气的时间,根据培训前检测中发现的不足采取针对性培训,再行培训效果检测。结果培训前心肺复苏操作总体合格率较低,尤其以按压过快为显,培训后合格率明显提高。结论受试人员培训前操作整体水平不高,经培训后明显改善。     

分解串连教学法在心肺复苏培训中的效果分析

目的探讨模拟现场分解、串连教学法在心肺复苏培训中的运用效果。方法回顾性分析我院2012至2013年对1 202名护士进行心肺复苏培训工作的效果。其中以2013年接受培训的学员作为实验组,采取分解-串连-自行练习-纠错-考试考核-提问问题的方法培训2010版心肺复苏。再以2012年接受培训的学员作为对照组,采取传统方法进行培训。比较分析两组学员的CPR流程掌握情况、考试时情绪紧张度、重点环节掌握情况、考试排斥度等。结果两组学员CPR流程标准的掌握、考试时情绪紧张度、重点环节掌握、考试排斥度等比较差异有统计学意义,实验组优于对照组,P0.05。结论现场分解-串连-自行练习-纠错-考试考核-提问问题的教学方法在心肺复苏操作培训中体现了教、学益彰,效果满意,值得在心肺复苏以及其他护理操作培训中推广。     

院前心肺复苏模式的探讨

目前国内心肺复苏特别是院前急救，缺少适合我国国情的操作模式(指南)，这也导致了我国急救复苏成功率远远低于欧美、日本等发达国家。结合我们工作经验，参阅国内外文献．就心肺复苏中人员、设备、观念、伦理道德、复苏顺序、药物使用、循证原则、终止标准等方面提出了一些看法，供急救业内同行参考。     

开展院前心肺复苏培训的必要性及措施

心肺复苏（CPR）是针对呼吸、心跳停止所采取的抢救措施。院前呼吸心跳骤停患者的生存率与旁观者及第一反应者采取的CPR有关,若能及时施以正确的CPR,可大大降低病死率,复苏成功率的决定因素是在现场必须有经过培训、有实施急救能力的第一目击者,因此建立省、地（市）、县三级管理的培训体系,开展CPR的培训工作,让公众掌握CPR技能以作为第一目击者参与呼吸心跳骤停的现场抢救,是提高院前CPR成功率的重要措施。     

老年人心肺复苏认知现状的调查

目的 通过对老年人心肺复苏的认知及需求状况调查,探讨对老年人进行心肺复苏知识与技能培训的方法和意义.方法 通过整群抽样的方法,选取长春市老年大学同期的92名60岁以上的非医务工作者作为研究对象,采用自行设计的问卷进行调查,并利用SPSS13.0统计软件对数据进行整理分析.结果 94.6%的被调查者表示对心肺复苏知识不熟悉,50%表示愿意参加心肺复苏学习;分别有57.6%和32.6%认为自己有能力学习和实施心肺复苏;老年人对亲近人的急救意愿较高,而对陌生人意愿较低;影响急救意愿的因素依次为:担心急救能力不足,怕引起纠纷和怕得传染病;有心血管疾病史者和无心血管疾病史者学习和实施心肺复苏的自信心有显著性差异.结论 应酌情在老年人中开展心肺复苏培训,使有能力的老年人在其家属发生居家心跳骤停时积极发挥"第一目击者"的作用.     

心肺复苏机与徒手心肺复苏临床疗效的研究

目的 分析使用心肺复苏机与徒手心肺复苏抢救心脏呼吸骤停患者的临床疗效.方法 选取来院心脏呼吸骤停的87例患者为研究对象,其中49例均采用CPR model 心肺复苏,为实验组;其余38例采用徒手心肺复苏,为对照组.结果 实验组平均动脉压、血氧分压、血氧饱和度、有效率均显著优于对照组(P<0.05),并发症发生率显著低于对照组(P<0.05),而两组间复苏成功率无显著性差异(P>0.05).结论 心肺复苏机比徒手心肺复苏能更好的改善心脏呼吸骤停患者的平均动脉压、血氧分压、血氧饱和度,但不能挽救更多的患者生命.     

探讨医学院校与社区联合对社区居民进行心肺复苏培训的可行性及效果

目的:探究分析医学院校与社区联合对社区居民进行心肺复苏培训的可行性及效果.方法:本次研究采用随机整群抽样的方法,从南阳医专较近的一个社区从随机抽取100名居民为调查对象,采用双色球随机分组法将100名居民平均分为观察组和对照组,对照组在社区接受常规心肺复苏培训,观察组除常规心肺复苏培训外,还会进入到医学院校实验室学习,...     

心肺复苏技能培训效果在心脏病患者家属与一般人群间的比较

目的:比较在社区居民不同对象进行心肺复苏技能培训的效果。方法:将心力衰竭(心衰)患者亲属作为亲属组,与一般人群组成的普通组(对照组)进行比较,两组人群经过同样培训后,进行相同的知识、技能考核,利用知识问卷分数、技能操作分数、生命体征判断正确率、心肺复苏操作准确率等观察指标进行培训效果评价。结果:亲属组各项指标均显著高于普通组(均P0.05)。结论:在社区人群急救培训中,组织者只有针对特定人群进行特定内容的教育与培训,才能达到应有的效果。     

萨勃心肺复苏机抢救心脏骤停患者的效果

目的 评价心肺复苏机抢救心脏骤停患者的治疗效果。方法 将院内抢救的247例心脏骤停患者随机分为两组,分别用萨勃机进行心肺复苏（萨勃机组,n=112例）和采用标准心肺复苏法进行复苏（标准复苏组,n=135例）,除颤、药物应用等基本相同。比较两种方法对心肺复苏成功率及存活率的影响。结果 两组患者抢救开始前的临床状况（年龄、性别、心率、呼吸频率、血压、血氧饱和度和病因类别等均无显著差异,萨勃机组复苏成功率（46.4%）和患者存活率（16.1%）均显著高于标准复苏组（分别是11.1%和4.4%）,差异有统计学意义（均P<0.05）。结论 萨勃机急救心脏骤停患者的效果优于标准心肺复苏法。     

心肺复苏辅助装置和团队心肺复苏的研究进展

高质量的胸外按压是高质量心肺复苏的核心.心肺复苏辅助装置和团队心肺复苏可改善人工胸外按压的低效能,因此在心搏骤停抢救中使用越来越广泛.现主要对心肺复苏辅助装置的原理、研究进展、应用前景和团队心肺复苏的发展理念进行综述.     

社区医生急救技术培训模式与效果评价研究

目的探索一套便捷、高效的社区医生急救技术培训模式,同时对我街道所属社区医生进行规范化培训以提高其院前急救能力。方法将容桂街道所属13个社区卫生服务站每站点选取2名医生作为培训对象,随机抽取1名作为A组学员,另一名作为B组学员,每组共13名学员。A组学员采用传统教学方法即＂理论讲授-实践技能操作-考核＂三步骤进行;B组采用＂逆向补充教学法＂进行培训,A、B两组总培训时间均为2周。学习期满进行考核及1年后随访两组学员在1年内使用急救技术实施急救的能力和效果。结果学习期满实践考核成绩B组较A组好,考核达标培训所需时间B组较A组少,1年内急救技术应用能力二者无显著差异。结论＂逆向补充教学法＂在实施急救技术培训中省时省力,针对性强,学员学习效果好。     

Development of a Screening Questionnaire for the General Hospital and General Practices

The purpose of this study was to develop a sensitive as well as brief screening questionnaire by combining the well-known instruments CAGE and the Michigan Alcoholism Screening Test (MAST) in detecting patients with alcohol dependence or abuse in general hospitals and general practices. The number of items was reduced by means of logistic regression and item analysis based on data of 1, 167 consecutive admissions of a general hospital who completed both questionnaires. Further data were derived from a sample of 774 patients from 10 randomly selected general practices. A solution with nine items was validated in a second sample of 436 hospital inpatients. In all three samples, cases screening positive were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry to provide ICD-10 and DSM-Ill-R or DSM-IV diagnosis. In addition, 103 subjects with negative screening results were interviewed in the second general hospital sample. On grounds of the data of all three samples, a solution of seven items was chosen. This instrument comprises two CAGE and five MAST questions (Luebeck Alcohol Dependence and Abuse Screening Test; LAST) and was significantly higher in sensitivity than CAGE and SMAST. Data were robust in all three samples. It is concluded that the LAST is an optimized instrument for use in general hospital and general practice.     

综合性医院肺动脉栓塞的误诊分析

目的 :提高综合性医院临床医师对肺动脉栓塞 (PE)的认识及诊断水平。方法 :对 42例PE患者的基础疾病、临床表现、辅助检查、误诊病种、误诊时间、疗效及转归等有关临床资料进行回顾性分析。结果 :PE临床表现差异性大 ,误诊率高 ,本组误诊率达 78.6 %。误诊时间长 ,2周内确诊率仅为 45 .2 %。结论 :综合性医院临床医师应提高对PE的诊断意识 ,重视高危因素 ,仔细询问症状 ,充分利用相关检查 ,提高PE的诊断率。     

Chest Compression Force of Trained and Untrained CPR Rescuers

The objective of this study was to measure the force exerted by 83 trained CPR rescuers and 104 untrained adult laypersons (college students and staff). A bathroom scale was used to measure the force exerted by these subjects with their hands on the bathroom scale in the CPR position. The weight range for both groups was the same. Of the trained rescuers, 60% pressed with more than 125 lbs, whereas only 37% of the laypersons pressed with more than 125 lbs. In view of the American Heart Association (AHA) guidelines (2000) to depress the chest 1.5 to 2 inches, which requires 100–125 lbs, it would appear that most laypersons do not exert enough force for effective CPR.     

Insulin and glucose levels during CPR in the canine model

Cardiopulmonary arrest and resuscitation produces tremendous physiological stress with resultant biochemical derangements. We undertook this study to determine insulin and glucose levels during cardiopulmonary arrest in the canine model. Baseline insulin and glucose levels were obtained from an ascending aortic arch catheter in six mongrel dogs. Ventricular fibrillation was induced by an electrical stimulus and ventilation was terminated. After five minutes of fibrillation, cardiopulmonary resuscitation (CPR) was initiated using external, mechanical CPR and a continuous epinephrine infusion at 5 micrograms/kg/min. Serum insulin and glucose levels were repeated 15 minutes after beginning CPR. Mean blood glucose 15 minutes after initiation of resuscitation (379 +/- 114 mg/dL) was significantly increased from prearrest levels (124 +/- 29 mg/dL, P less than .01). Mean serum insulin 15 minutes after initiation of resuscitation (11.3 +/- 3.3 microU/mL) was significantly decreased compared to prearrest levels (16.2 +/- 6.0 microU/mL, P less than .05). During ischemia, the myocardium becomes dependent primarily on glucose as a source of energy. Inappropriately low insulin levels during CPR may adversely affect an already compromised myocardial glucose metabolism. Further investigation is needed to determine the utility of insulin infusion during CPR.     

Comparison of clinical CPR studies in Milwaukee and elsewhere in the United States

As we mark the 25th anniversary of the clinical application of closed-chest cardiopulmonary resuscitation (SCPR), it is time to look back and analyze the progress we have made in the resuscitation of sudden death syndrome. Recent studies of SCPR's effectiveness have yielded mixed results, in comparison to early studies that were universally favorable. The continued toll of neurologic injury following SCPR resuscitation, and reinforcement of the importance of defibrillation in resuscitation, stimulate us to find improved forms of SCPR and improved methods of resuscitation delivery in emergency medical systems.     

急诊科心肺复苏术成功率影响因素分析

目的探讨急诊科心肺复苏成功率的影响因素,以利提高急诊科救治水平。方法回顾性分析326例患者实行心肺复苏救治的过程。结果患者性别和肾上腺素使用方法与心肺复苏的成功率无关;有无目击者及是否及时除颤与心肺复苏的成功率有关（P〈0．05）;有无目击者、是否专业急救人员、是否启动EMSS、是否5min内心肺复苏与心肺复苏的成功率有关（P〈0．01）。结论普及心肺复苏急救知识,提高公众急救意识,加强急诊科建设及专业素质培养,可提高抢救成功率。     

Human C-peptide immunoreactivity (CPR) in blood and urine — Evaluation of a radioimmunoassay method and its clinical applications

Summary A double-antibody radioimmunoassay method, using synthetic human connecting peptide as an immunizing antigen and standard, was evaluated for clinical assay of blood and urine samples. Normal fasting blood connecting peptide immunoreacivity (CPR) was 2.45±0.96 ng/ml, increasing promptly after a 50 g oral glucose load, but somewhat slower than insulin. Molar concentration of CPR exceeded that of insulin. CPR responses to glucose were subnormal in diabetics, very low in juvenile-type cases, and often poor in patients on insulin treatment. Fasting CPR levels were elevated in patients on corticosteroid treatment and with uraemia. A patient with insulin auto-antibod had high serum CPR. A considerable amount of CPR appeared in urine. Normal daily excretion of CPR was 1.52±0.55 g/kg or 55.1±18.2 ng/mg creatinine. Urine CPR was very low in juvenile-type diabetics, and elevated in patients on corticosteroid treatment. The results confirm that blood and urine CPR are useful measures of the endocrine pancreatic function.