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1、临床路径对急救小组心肺复苏质量效能改进【摘要】目的探讨临床路径对急救小组复苏效能的改进效果。方法设计心搏骤停院前救治临床路径，通过模拟病例对杭州市急救中心一线急救小组实施培训，对培训前后的各项救治指标进行测评、比对。结果符合条件的45个急救小组培训前现场实滋心电监护、气管插管、开通静脉的仅8(17.8%)、5(11.1%).6(13.3%)组，前3min中断按压时间(102.13±13.68)s,辅助人员球囊成功通气比例0.37±0,09,现场心电取证、告知签字仅8组(17.8%)、6组(13.3%),复苏与取证能同时进行的仅2组(4.4%)。培训
2、后心电监护、气管插管、开通静脉分别达到45组(100%)、43组(95.6%)、43组(95.6%),按压中断时间缩短到(69.73±7.66)s,成功通气比例0.57±0.12；现场心电取证、告知签字取证分别达到了40组(88.9%)、43组(95.6%),复苏取证同时进行达到了36组(80.0%)o结论院前心肺复苏质量低下，临床路径是急救小组实现院前心肺复苏从高风险低效能到低风险高效能转变的有效工具，在现有体制机制下值得推广运用。【关键词】心搏骤停；心肺复苏；临床路径；院前急救;培训Theimprovementofcardiopulmonary
3、resuscitation(CPR)efficiencybyrescuetearnthroughtheclinicalaccesstopre-hospitalcareZHANGJun-geng,FUWei-ling,QianLi-na，LUMei-li.HangzhouPre-hosptialCareCenter,Hangzhou310006,China[Abstract】ObjectiveToexploretheimprovementofcardiopulmonaryresuscitation(CPR)efficiencybyrescueteam
4、throughtheclinicalaccesstopre-hospitalcare.MethodsAfterestablishmentofclinicalapproachestocardiacarrest,thetrainingprogramoffirstlinepersonnelofrescueteamsintheHangzhouEmergencyCenterwascarriedoutwithpracticeonsimulatedpatientsandscenario.Atotalof45eligibleteamswererandomlyenr
5、olledforstudybyobservingtheperformanceofsomeessentiolresuscitationtechniquesbeforeandaftertraining.ResultTheefficiencyofresuscitationperformedbyrescuetearnforcardiacarrestwasgenerallynotgoodenoughbeforetrainingevidencedbytheshortageofapplicationofECGmonitoring,endotrachealintu
6、bationsandestablishingintravenous1inewhichwereonly8(17.8%),5(11.1%),6(13.3%),respectively,andtheinterruptiontimeofchestcompressionduringthefirstthreeminuteswas(102.13±13.68)secondsandthesuccessfullyartificialrespirationratiosbyassistantmemberswas(0.37±0.09)，andratiosofECGforen
7、sicsandwritteninformconsentwere8(17.8%)and6(13.3%)respectively,CPRandforensicsdonesimultaneouslywasonly2(4.4%).TheefficiencyofrescueforcardiacarrestwasobviouslyimprovedaftertrainingbytheclinicalapproachesprovedbytheincreaseinapplicationofECGmonitoring,endotrachealintubations,i
8、ntravenouslinesetupreachedto45(100%),43(95.6%),43(95.6%),resp
