Colleges join forces to issue guidance on resuscitation training
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《英国医生杂志》
Four major professional medical organisations have joined forces to try to improve the standard of training for staff involved in resuscitation and to improve resuscitation provision in the United Kingdom.
The guidelines, from the Royal College of Anaesthetists, the Royal College of Physicians, the Intensive Care Society, and the Resuscitation Council, have been drawn up to address perceived variations from one healthcare facility to another in the level of treatment received.
Although at the moment individual hospitals?resuscitation rates are not available, and are therefore not used as performance indicators, the Healthcare Commission may introduce them from April 2005 as one of its criteria for measuring performance against government standards for health care, according to Professor Gary Smith, co-chairman of the working group and a consultant in intensive care.
Each year about 43 000 patients in hospitals have a cardiac arrest. According to research by T J Hodgetts and colleagues (Resuscitation 2002;54:115-23) an estimated 20 000 of cardiac deaths in hospital each year are avoidable. These are not people arriving in hospital with a heart attack but patients who are admitted for some other reason, such as surgery, or who contract pneumonia and deteriorate.
The guidelines call for more effective monitoring of patients to avoid heart attacks in the first place.
揂lthough some cardiac attacks are expected, that is a very small amount,?said Professor Smith. 換uite often we find patients have other medical conditions. Their deterioration is often unrealised by the ward staff.?/p>
Often this could be seen by quite simple signs, such as changes in the patient抯 respiratory rate, blood pressure, or colour, he said. Early intervention could help avoid a heart attack, he said.
It is not just hospitals but also primary care trusts, ambulance trusts, and even general practices that need to have guidelines on training and practice, says the statement. This could include training hospital porters and reception staff on basic resuscitation techniques.
揢p until now, there have been no nationally agreed guidelines for standards of education, and training and facilities and practices have been variable,?the statement says.
Among the recommendations it calls for:
All healthcare institutions to have a resuscitation committee and, where appropriate, a resuscitation team;
All institutions to have at least one resuscitation training officer;
Staff who have contact with patients to be given basic resuscitation training;
Clinical staff to be given training in recognising and preventing cardiac arrest; and
Resuscitation equipment to be available throughout the institution.
It also calls for appropriately trained staff to be continuously available to manage cardiopulmonary arrest in hospitals that admit acutely ill patients.
揥e have a national obligation to provide an effective resuscitation service in healthcare institutions admitting acutely ill patients,?said Dr David Gabbott, co-chairman of the working group and a consultant anaesthetist.(London Lynn Eaton)
The guidelines, from the Royal College of Anaesthetists, the Royal College of Physicians, the Intensive Care Society, and the Resuscitation Council, have been drawn up to address perceived variations from one healthcare facility to another in the level of treatment received.
Although at the moment individual hospitals?resuscitation rates are not available, and are therefore not used as performance indicators, the Healthcare Commission may introduce them from April 2005 as one of its criteria for measuring performance against government standards for health care, according to Professor Gary Smith, co-chairman of the working group and a consultant in intensive care.
Each year about 43 000 patients in hospitals have a cardiac arrest. According to research by T J Hodgetts and colleagues (Resuscitation 2002;54:115-23) an estimated 20 000 of cardiac deaths in hospital each year are avoidable. These are not people arriving in hospital with a heart attack but patients who are admitted for some other reason, such as surgery, or who contract pneumonia and deteriorate.
The guidelines call for more effective monitoring of patients to avoid heart attacks in the first place.
揂lthough some cardiac attacks are expected, that is a very small amount,?said Professor Smith. 換uite often we find patients have other medical conditions. Their deterioration is often unrealised by the ward staff.?/p>
Often this could be seen by quite simple signs, such as changes in the patient抯 respiratory rate, blood pressure, or colour, he said. Early intervention could help avoid a heart attack, he said.
It is not just hospitals but also primary care trusts, ambulance trusts, and even general practices that need to have guidelines on training and practice, says the statement. This could include training hospital porters and reception staff on basic resuscitation techniques.
揢p until now, there have been no nationally agreed guidelines for standards of education, and training and facilities and practices have been variable,?the statement says.
Among the recommendations it calls for:
All healthcare institutions to have a resuscitation committee and, where appropriate, a resuscitation team;
All institutions to have at least one resuscitation training officer;
Staff who have contact with patients to be given basic resuscitation training;
Clinical staff to be given training in recognising and preventing cardiac arrest; and
Resuscitation equipment to be available throughout the institution.
It also calls for appropriately trained staff to be continuously available to manage cardiopulmonary arrest in hospitals that admit acutely ill patients.
揥e have a national obligation to provide an effective resuscitation service in healthcare institutions admitting acutely ill patients,?said Dr David Gabbott, co-chairman of the working group and a consultant anaesthetist.(London Lynn Eaton)