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袋管手动通风的儿科复苏技能:开发和使用移动模拟程序来评估多专业的PICU团队的能力
Anna E McCormick1,2, Stuart H Friess1, Kimberly S Quayle3
1Division of Critical Care, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO.
概括
儿科重症监护室 (PICU) 团队成员在使用充气袋的手动通风技能中表现出低的成功率和可变的信心. 移动模拟可以帮助改善这些关键的呼吸护理技术.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 呼吸系统疗法 呼吸系统疗法
- 医疗模拟 医疗模拟
背景情况:
- 手动通风是儿科重症监护室 (PICU) 中的一个关键技能.
- 充气袋是用于手动通风的常见工具,但其有效使用需要熟练使用.
- 在多专业团队中评估和改进人工通风技能对于患者安全至关重要.
研究的目的:
- 评估多专业的PICU团队成员在使用流量膨胀袋进行袋管手动通风方面的熟练程度.
- 在PICU环境中确定手动通风技术的特定弱点.
- 探索移动模拟对于技能评估和呼吸护理培训的实用性.
主要方法:
- 在2022年1月至4月的学术PICU中进行了前性观察研究.
- 在现场移动模拟被用来评估袋管手动通风技能,使用流量膨胀袋.
- 129名多专业的PICU团队成员 (护士,呼吸治疗师,执业护士,研究员,护理人员) 执行了定时通风任务,这些任务被录制为视频.
主要成果:
- 只有4%的参与者成功实现了所有目标通风参数 (压力,速率,弹出).
- 参与者经常比目标更低的压力和更快的呼吸率.
- 保持目标阳性末尾呼气压 (PEEP) 是最不成功的参数 (19%的成功率);与其他专业相比,护士在实现目标压力方面表现不佳.
结论:
- 多专业的PICU团队成员在使用流量膨胀袋进行手动通风的信心和性能上表现出显著的变化.
- 观察到的表现表明,在实现关键通风目标,特别是PEEP方面,成功率很低.
- 移动模拟单元为专业特定的指导提供了一个平台,以提高床边手动通风的质量.
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