Doktorların Prone Kardiyopulmoner Resüsitasyon Bilgi ve Uygulamaları: Bir Anket Çalışması

Yıl 2023, Cilt: 6 Sayı: 2, 66 - 71, 30.06.2023

Murat Genç , Gül Pamukçu Günaydın , Çağdaş Yıldırım

https://doi.org/10.54996/anatolianjem.1171693

Cited By: 1

Öz

Amaç: Prone KPR özellikle son dönemde COVID-19 pandemisiyle birlikte tekrar gündeme gelmiştir. Prone pozisyonda takip edilen ileri havayolu olan hastalarda ya da prone pozisyonda opere edilen hastalarda gelişen arrestin yönetilmesinde Prone KPR kullanılabilir.
Hastaların prone takip edildiği acil servis ve yoğun bakımlarda çalışan hekimlerin bu konuda bilgi sahibi olması önem arz etmektedir. Bu çalışmada acil servis ve yoğun bakım hekimlerinin prone KPR konusunda eğitim alıp almadığı, bilgi düzeyi ve prone KPR uygulayıp uygulamadığının belirlenmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışmamız Aralık 2020-Mart 2021 tarihleri arasında şehir merkezinde yıllık yaklaşık 650000 acil başvurusu ve 700 yoğun bakım yatağı olan bir hastanede çalışan hekimlerin katıldığı bir anket çalışmasıdır. Katılımcılara 18’u demografik bilgiler ve eğitim durumlarını sorgulayan, 6’sı teorik bilgi ölçen toplamda 24 soruluk anket yöneltilmiştir. Verilerin analizi IBM SPSS 16.0 for Windows programında gerçekleştirilmiş ve anlamlılık değeri p < 0,05 olarak kabul edilmiştir. Çalışmamız Ankara Yıldırım Beyazıt Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu’nun 16.12.2020 tarih ve 118 sayılı kararı ile etik ve bilimsel açıdan uygun bulunmuştur.

Bulgular: Çalışmaya 85’i asistan hekim, 27’si uzman hekim olmak üzere toplam 112 hekim katıldı. Katılımcıların 101’i acil serviste çalışırken 11’i yoğun bakımda çalışmaktaydı. Verilen yanıtlar incelendiğinde katılımcıların çoğunluğunun prone hasta takip etmiş olmasına rağmen daha önce prone KPR ile ilgili eğitim almadığı (%86,6) ve prone KPR yapmadığı (%92) gözlendi.

Sonuç: COVİD-19 sırasında prone hasta takibi ve prone KPR artmış olmasına rağmen hekimlerin prone KPR konusunda bilgi ve deneyim eksikliği devam etmekte olup, bu konuya KPR eğitimlerinde yer verilmesine ihtiyaç vardır.

Anahtar Kelimeler

Kardiyopulmoner resüsitasyon, prone pozisyon, acil tıp

Knowledge and Practice of Prone Cardiopulmonary Resuscitation Among Physicians: A Survey Study

Öz

Aim: Prone CPR has gained popularity recently during the COVID-19 pandemic. Prone CPR can be used to manage cardiopulmonary arrest in patients who are being treated in a prone position with an advanced airway in place or in patients who are being operated on in the prone position. It is important that physicians who work in the emergency department and intensive care units, where patients are treated in a prone position, have knowledge about prone CPR. In this study, our goal was to determine emergency department and intensive care physicians’ level of knowledge about prone CPR as well as whether they have received training on prone CPR and whether they have applied prone CPR in their practice.

Material and Methods: This study surveyed physicians working in a hospital in the city center with approximately 650,000 emergency department presentations aannually and 700 intensive care beds; the survey was conducted between December 2020 and March 2021. The participants were asked a total of 24 question, 18 of which elicited demographic information and educational status and six of which measured theoretical knowledge about prone CPR. The analysis of the data was performed using IBM SPSS 16.0 for Windows, and the significance value was accepted as p < 0.05.

Results: A total of 112 physicians participated in the study, 85 of whom were residents and 27 of whom were specialists. While 101 of the participants were working in the emergency room, 11 were working in the intensive care unit. The data indicated that, although the majority of the participants followed prone patients, they had not received training on prone CPR (86.6%) and did not perform prone CPR (92%).

Conclusion: Despite the increase in the number of patients followed in prone position and the use of prone CPR during the COVID-19 pandemic, physicians’ lack of knowledge and experience with prone CPR continues; therefore, prone CPR needs to be included in CPR education.

Anahtar Kelimeler

Cardiopulmonary resuscitation, prone position, emergency medicine

Kaynakça

• McNeil EL. Re-evaluation of cardiopulmonary resuscitation. Resuscitation. 1989;18(1):1-5. doi:10.1016/0300-9572(89)90107-x
• Anez C, Becerra-Bolaños Á, Vives-Lopez A, Rodríguez-Pérez A. Cardiopulmonary Resuscitation in the Prone Position in the Operating Room or in the Intensive Care Unit: A Systematic Review. Anesth Analg. 2021;132(2):285-292. doi:10.1213/ANE.0000000000005289
• Ghelichkhani P, Esmaeili M. Prone Position in Management of COVID-19 Patients; a Commentary. Arch Acad Emerg Med. 2020;8(1):e48. Published 2020 Apr 11.
• Moscarelli A, Iozzo P, Ippolito M, et al. Cardiopulmonary resuscitation in prone position: A scoping review. Am J Emerg Med. 2020;38(11):2416-2424. doi:10.1016/j.ajem.2020.08.097
• Edelson DP, Sasson C, Chan PS, et al. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association. Circulation. 2020;141(25):e933-e943. doi:10.1161/CIRCULATIONAHA.120.047463
• O'Connor RE, Al Ali AS, Brady WJ, et al. Part 9: Acute Coronary Syndromes: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18 Suppl 2):S483-S500. doi:10.1161/CIR.0000000000000263
• Golestani-Eraghi M, Mahmoodpoor A. Early application of prone position for management of Covid-19 patients. J Clin Anesth. 2020;66:109917. doi:10.1016/j.jclinane.2020.109917
• Telias I, Katira BH, Brochard L. Is the Prone Position Helpful During Spontaneous Breathing in Patients With COVID-19?. JAMA. 2020;323(22):2265-2267. doi:10.1001/jama.2020.8539
• Brown J, Rogers J, Soar J. Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review. Resuscitation. 2001;50(2):233-238. doi:10.1016/s0300-9572(01)00362-8
• Mazer SP, Weisfeldt M, Bai D, et al. Reverse CPR: a pilot study of CPR in the prone position. Resuscitation. 2003;57(3):279-285. doi:10.1016/s0300-9572(03)00037-6
• Wei J, Tung D, Sue SH, Wu SV, Chuang YC, Chang CY. Cardiopulmonary resuscitation in prone position: a simplified method for outpatients. J Chin Med Assoc. 2006;69(5):202-206. doi:10.1016/S1726-4901(09)70219-9
• Tofil NM, Dollar J, Zinkan L, et al. Performance of anesthesia residents during a simulated prone ventricular fibrillation arrest in an anesthetized pediatric patient. Paediatr Anaesth. 2014;24(9):940-944. doi:10.1111/pan.12406
• Sinha T, Stinehart K, Moorer C, Spitzer C. Cardiopulmonary Arrest and Resuscitation in the Prone Patient: An Adult Simulation Case for Internal Medicine Residents. MedEdPORTAL. 2021;17:11081. Published 2021 Feb 11. doi:10.15766/mep_2374-8265.11081
• Chapter 4 Testing In: Advanced Cardiovascular Life Support: Instructor's Manual. American Hearth Association, 2020.
• Llópiz, Y. M., & Mesa, C. F. (2017). Knowledge on cardiopulmonary resuscitation in the Internal Medicine Department: Scenario of the crash carts. CorSalud (Revista de Enfermedades Cardiovasculares), 9(4), 263-268.