摘要
目的分享《深圳市宝安区中小学生分层应急救护培训工作方案》的执行经验,并观察其培训效果。方法选择2018年8月至2019年8月在深圳市宝安区应急医疗救援培训中心进行急救培训的中小学生为研究对象,记录学生人数、出勤导师数量、心肺复苏(CPR)培训模型及自动体外除颤仪(AED)培训模型的使用次数。将培训学生按3个学龄层次由浅到深增加授课内容及深度:小学生包括正确拨打120、意外伤害识别小动画、AED和海姆立克手法演示、CPR训练,用时40 min;初中生包括正确拨打120、意外伤害识别及简单处置、CPR及AED的应用、CPR训练、跟学AED及海姆立克手法等,用时90 min;高中生包括正确拨打120、意外伤害识别及正确处置、院外心搏骤停(OHCA)的识别、CPR及AED的要点、CPR及AED操作练习、海姆立克手法及止血包扎等,用时120 min。课程结束后,小学生采用志愿考核;初中生仅小班制需考核,大班没有考核要求,仅进行展示;高中生则须全部强制性考核。收集不同层次学生急救培训基本情况,比较不同层次学生CPR及AED培训模型使用情况、急救相关比例分布情况、急救培训考核通过情况的差异。结果200期急救培训中共有12896名学生和2086人次培训导师参与,共使用8557次CPR培训模型及8493次AED培训模型,每场学生平均(65.27±5.61)名,需要(10.52±10.43)名培训导师和(43.09±19.06)个CPR培训模型及(42.77±18.61)个AED培训模型。学生与培训导师的比例为1∶(6.07±1.47),学生与CPR培训模型的比例为1∶(1.54±1.02),学生与AED培训模型的比例为1∶(1.54±1.03);最终有10494名学生参加考核,考核参与率为81.37%;10114名学生通过考核,考核通过率为96.38%。分层分析显示:与小学生比较,初中生平均每场培训人次明显增加(名:69.94±8.77比58.69±6.12,P<0.05),高中生平均每场培训人次明显减少(名:57.35±5.79比58.69±6.12,P<0.05),初中生培训导师比例明显降低(5.94±1.39比6.48±2.02,P<0.05),初中生和高中学生的考核率明显升高〔81.07%(6667/8224)、100%(2313/2313)比64.18%(1514/2359),均P<0.05〕,通过考核率明显降低〔95.47%(6365/6667)、96.88%(2241/2313)比99.60%(1508/1514),均P<0.01〕,这可能与小学生考核难度较低和志愿性考核比例低等原因有关。结论分层次进行中小学生急救培训对提高培训效果具有可行性,课程设置内容应由浅至深,同时应配置足够培训导师和培训模型。
Objective To share the implementation experience of hierarchical first aid training scheme for elementary and middle school students in Baoan District of Shenzhen City and evaluate its effect of training.Methods During August 2018 and August 2019,elementary and middle schools students who participated in the first aid training held by emergency rescue training center of Baoan District were enrolled.Baseline information including the number of students,the number of attending tutors,the number of cardiopulmonary resuscitation(CPR)training models,automated external defibrillator(AED)models were recorded.According to hierarchical levels of three age,students received different courses with content from simple to hard:the course of elementary school students was consisting of dialing 120,smart animation on how to identify accidental damage,demonstration of AED and Hemlick techniques,CPR practise(40 minutes).The course of junior high school students was consisted of how to dial 120,how to identify accidental damage and simple disposal,application of CPR and AED,practice CPR and AED and Hemlick techniques(90 minutes).The course of high school students was consisted of how to dial 120,identify accidental damage and right disposal,identification of out-of-hospital cardiac arrest,the key-point of CPR and AED,practice CPR and AED,Hemlick techniques and hemostatic bandage(120 minutes).At the end of course,elementary school students were voluntary for skill assessment;junior high school students only were compulsory for skill assessment in small classes but not required in large classes,just for demonstration;additionally,the whole high school students were compulsory for skill assessment.The characteristics of first aid training students at different levels were collected in order to compare the differences on the usage of CPR training model and AED training model,the distribution of emergency resource,the ratio for passing examination.Results A total of 12896 students and 2086 training instructors took parted in 200 lists of first aid training courses,8557 CPR models and 8493 AED models were used.On average,there are 65.27±5.61 students in each session,and 10.52±10.43 training instructors.There are 43.09±19.06 CPR training models and 42.77±18.61 AED training models.The mean ratio of student to tutor was 6.07±1.47,student to CPR model was 1.54±1.02,and student to AED model was 1.54±1.03.In the end of course,10494 students participated in the examination with the participation rate of 81.37%;10114 students passed the examination with the passing rate of 96.38%.Hierarchical analysis showed:compare to elementary school students,the average number of junior high school students in every training session significantly increased(cases:69.94±8.77 vs.58.69±6.12,P<0.05),but the average number of high school students in every training session significantly decreased(cases:57.35±5.79 vs.58.69±6.12,P<0.05).The proportion of instructors in junior high school students'training significantly reduced(5.94±1.39 vs.6.48±2.02,P<0.05).The examination ratio of junior high school students and high school students was increased significantly[81.07%(6667/8224),100%(2313/2313)vs.64.18%(1514/2359),both P<0.05],but the ratio of passing the examination was significantly reduced[95.47%(6365/6667),96.88%(2241/2313)vs.99.60%(1508/1514),both P<0.01].This might be related to the low difficulty of elementary school students'assessment and the low proportion of compulsory examination.Conclusions Hierarchical scheme is feasible for first aid training in elementary and middle school students,the content of course should be desighed from easy to hard.Synchronously,sufficient training instructors and training models should be equipped to ensure the quality.
作者
林锦乐
王从华
方怡玫
罗意
徐军
张文武
窦清理
于学忠
Lin Jinle;Wang Conghua;Fang Yimei;Luo Yi;Xu Jun;Zhang Wenwu;Dou Qingli;Yu Xuezhong(Department of Emergency Medicine,People's Hospital of Shenzhen Baoan District,Southern Medical University,Shenzhen 518100,Guangdong,China;Department of Emergency Medicine,Peking Union Medical College Hospital,Beijing 100730,China)
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2021年第9期1121-1125,共5页
Chinese Critical Care Medicine
基金
广东省深圳市医学重点学科建设项目 (SZXK047)
广东省深圳市高层次医学团队建设项目 (SZSM201606067)
广东省深圳市宝安区劳动模范和宝安区工匠创新工作室项目 (2020-10)。
关键词
社会急救培训体系建设"宝安模式"
中小学生急救培训
心肺复苏
自动体外除颤仪
培训导师
Construction of"Baoan Model"social emergency medicine training
First aid training for elementary and middle schools students
Cardiopulmonary resuscitation
Automated external defibrillator
Training instructor
