出诊医师参与电话指导目击者实施心肺复苏

目的 评估出诊医生参与电话指导目击者实施心肺复苏(CPR)的可行性和有效性,并探讨电话指导的方法及影响电话指导的相关因素.方法 回顾分析2008-01～2009-04 32例院前心脏骤停(CA)患者的救治方法,没有电话指导或指导不成功18例,目击者未实施CPR;出诊医生采用预先制定的电话指导方案成功给予了电话指导14例,目击者实施了CPR.比较两组的复苏结果,并计算通过电话指导方案正确识别CA的比率,目击者对出诊医师电话指导CPR的接受率及CPR正确率等.结果 电话指导目击者25例,接受指导19例(19/25,76%),不接受6例.经指导成功完成CPR 14例(14/19,73.7%),未完成5例.指导人员采用电话指导方案正确识别CA 17例(17/19,89.5%),目击者正确实施CPR 5例(5/14,35.7%).目击者行CPR 14例中院前成活5例(35.7%),目击者未行CPR 18例中院前成活1例(5.6%).院前成活率两组比较有统计学意义(P＜0.01).结论 出诊医生依据简化的电话指导CPR方案参与电话指导目击者实施CPR能提高CA院前复苏结果.但值得注意的是电话指导受诸多因素影响.

Emergency doctor telephone -directed cardiopulmonary resuscitation

Objective To evaluate the feasibility and effectiveness of emergency doctor telephone -directed cardiopulmonary resuscitation and explore the method of CPR instruction via telephone and factors that may impact implementation of telephone CPR. Methods 32 cases of out-of-hospital witnessed adult cardiac arrest were reviewed that occurred from January 2008 to April 2009, 18 cases of cardiac arrest victims did not received bystander CPR, 14 cases received bystander CPR through the instructions of emergency doctors with a simplified CPR instruction program. The outcomes between two groups were compared and the correct identification rate of CA through the T-CPR program and accepting T-CPR rate and correct CPR rate of bystanders were measured. Results 19 witnesses accepted the offer of T-CPR while 25 have been offered and 14 completed T-CPR. The correct identification rate of CA through the T-CPR program was 89.5%. The correct CPR rate of bystanders was 35.7%. The out-of-hospital survival rate was significantly better in the bystander CPR group (35.7%) than in the no-bystander CPR group (5.6%)(P<0.01). Conclusion Emergency doctor-assisted bystander CPR may increase survival rate in cardiac arrest and more factors may impact implementation of telephone CPR.