ABSTRACT
Objective To explore the better strategy of cardiopulmonary resuscitation (CPR) and electric defibrillation skills training and assessment on nurses in order to improve the first-aid level of nursing staff.Methods 1 258 nurses of a hospital were trained and assessed in batches.Core group and instruc -tor team were established,multimedia lecture,situation simulation training ahd network self-learning were available.Paperless examinations were conducted.Results of the examinations were analyzed by SPSS19.0,and the comparison between the two groups of independent samples were analyzed by Mann-Whitney U test.Results All the 1 258 nurses were qualified,for the median score was 88.0 and the quartile spacing was 7.5.The step-scores of step1-3,13,14,22,23 were high,while the step-scores of step5,7-17,16-21,24,25 were low.Compared with nurses without professional-titles,nurses with professional-titles got better results in total score,step 8-12 and step17-21,and the differences were statistically significant(P＜0.05).Conclusions It is necessary to pay attention to the training and assessment of CPR and electric defibrillation skills on nurses.Advanced and effective training methods need to be used to carry on regular training and assessment.For the weak links and low-grade nursing staff,intensive training needs to be conducted to improve the entire skill level of nurses.
ABSTRACT
Objective To explore the efficacy and safety of esmolol for the treatment of acute myocardial infarction patients with sympathetic storm.Methods Sixty acute myocardial infarction patients who suffered from sympathetic storm during the hospitalization from January 2013 to January 2015 in the People's Hospital of Baoji City.The patients were randomly divided into two groups : esmolol group(patients were treated with cardioversion or electric defibrillation and esmolol, n =30) and control group (patients were treated with cardioversion or electric defibrillation and amiodarone, n =30).Results The effective rate of esmolol group was 93.33％ (28/30), of control group was 70.00％ (21/30), and the difference was significant (x2 =5.455, P =0.020).The success rate of esmolol group which terminated sympathetic storm was significantly higher than control group (28％ vs.20％, P =0.020).Recurrence of ventricular tachycardia or ventricular fibrillation after esmolol treatment was significantly lower, the corresponding were less (3.30± 2.76 vs.6.83 ± 4.58, P =0.001).Esmolol group was no occurrence of hypotension that could not be corrected or severe slow arrhythmia.NTproBNP level between the two groups was not statistically significant observation (P ＞ 0.05).Conclusion Esmolol treatment of sympathetic storm is better efficacy, safety and be worthy of clinical application.
ABSTRACT
Objective To investigate the techniques of electrical defibrillation and their application to cardiopulmonary re-suscitation(CPR).Methods On the basis of reviewing the definition of electrical defibrillation,the main defibrillation tech-niques and their developments were introduced,as well as the selection of shock energy.The role that defibrillation played during CPR was defined according to the consensus.Results As an unfashionable technique,monophasic waveforms was inclined to be replaced by present biphasic waveform including biphasic truncated exponential(BTE) waveform and recti-linear biphasic waveform(RBW).The selected shock energy varied with the waveform that a defibrillator made use of,i.e.a monophasic defibrillator required a higher energy level as usual,whereas a biphasic one did not.It was deemed that biphasic technique presented an excellence in less damage to heart in addition to higher rate of successful defibrillation.In the critical care for sudden cardiac arrest with a shockable rhythm,the protocol of "1 shock + 5 cycles of CPR" should be recommended.Conclusion Electrical defibrillation techniques consist mainly of monophasic waveform and biphasic wave-form,between which the latter gains an advantage over the former.On the grounds of modern emergency medicine,defib-rillation has to be performed in combination with CPR.