Adherence to CPR guidelines during perioperative cardiac arrest in a developing country
Adherence to CPR guidelines during perioperative cardiac arrest in a developing country
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DOI：
10.1016/j.resuscitation.2005.10.012
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发表时间：
2006-06-01
期刊：
影响因子：
6.5
通讯作者：
Akinlaja, Olufunke
中科院分区：
文献类型：
--
作者：
Desalu, Ibironke;Kushimo, Olusola;Akinlaja, Olufunke
研究背景和目的：心肺复苏是麻醉训练的重要组成部分。在尼日利亚，这些技能主要在医学院和研究生培训期间教授。2000年采用了国际准则，2005年11月又制定了新的准则。这项研究旨在评估如何密切麻醉师在尼日利亚教学医院遵守2000 guidelines.Materials and Methods：所有围手术期心脏骤停发生在1年期间的成年人进行了前瞻性研究。所有< 15岁的患者和在麻醉师直接监督之外发生的心脏骤停均被排除在外。记录心脏骤停的时间和持续时间，心脏骤停的节奏和管理沿着即时outcome.Results：13心脏骤停发生在2147例围手术期（发病率：6/1000）。7例患者有非室颤/无脉性室性心动过速（VF/VT）节律。患者的平均年龄为30.23 ± 11.06岁。所有病例均采用经口气管插管、100%O2手动通气和胸外按压。平均停搏时间为25.66 ± 13.34 min。所有患者均接受肾上腺素（肾上腺素）和阿托品治疗。肾上腺素剂量之间的中位间隔为7.5分钟。只有一个周期的除颤给予VF/VT患者。5例患者（38.46%）立即存活。结论：我院麻醉医师未正确应用复苏指南。有组织的模拟实践的策略导致知识和技能的缺乏。有必要根据指导方针对所有麻醉师进行基本和高级复苏方面的持续培训。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
Background and goal of study: Cardiopulmonary resuscitation (CPR) is an integral part of anaesthetic training. In Nigeria, these skills are taught mainly during medical school and postgraduate training. International guidelines were introduced in 2000 and new guidelines were produced in November 2005. The study sought to assess how closely anaesthetists in a Nigerian teaching hospital abide by the 2000 guidelines.Materials and methods: All perioperative cardiac arrests in adults that occurred in a 1-year-period were studied prospectively. All patients < 15 years and cardiac arrests occurring outside the direct supervision of the anaesthetists were excluded. Time and duration of arrest, cardiac arrest rhythm and management were documented along with immediate outcome.Results: Thirteen cardiac arrests occurred in 2147 perioperative cases (incidence: 6/1000). Seven patients had non ventricular fibrillation/pulseless ventricular tachycardia (VF/VT) rhythms. The mean age of patients was 30.23 +/- 11.06 years. Orotracheal intubation, manual ventilation with 100% 02 and external chest compressions were instituted in all cases. The mean duration of arrest was 25.66 +/- 13.34 min. All patients received adrenaline (epinephrine) and atropine. The median interval between adrenaline doses was 7.5 min. Only one cycle of defibrillation was given to patients in VF/VT. Immediate survival occurred in five patients (38.46%).Conclusion: Anaesthetists in our hospital are not applying proper resuscitation guidelines. The tack of organised simulation practice resulted in deficient knowledge and skills. There is a need for continuing training in basic and advanced resuscitation for all anaesthetists according to the guidelines. (c) 2005 Elsevier Ireland Ltd. All rights reserved.