Objective To explore the application effect of cross-team scenario simulation exercise in the training of fire emergency plan in operating room.Methods Totally 48 nurses,16 anesthetists and 16 workmates in operating room of Zhejiang Provincial People′s Hospital from January 2015 to March 2016 were selected and divided into eight groups. The training of fire emergency plan in operating room was carried out with the method of scenario simulation exercise. The system of exercise contained three phases. The first phase was the theoretical study;the second phase was a teaching of centralized operation exercise;the third phase was the exercise in groups according to the design of simulation scenarios. The score was evaluated according to the method of subjective comment with over 80 points as the qualified,and below 79 points as the unqualified. At the same time,the time of completing the process before and after the exercise was recorded.Results The mean score of exercise examination was (88.75±4.23) points among eight groups with six groups whose scores were more than 90 points. When the small fire in operating room could be put out within three minutes by themselves,the time from the occurrence of fire to the restart of surgery after training (428.8±19.1) s was less than that (605.0±17.9) s before training with a significant difference (P<0.05). When the big fire in operating room could not be put out within three minutes by themselves,the time of retreat after training (44.6±4.2) s was less than that (71.0±6.4) s before training with a significant difference (P<0.05).Conclusions The cross-team scenario simulation exercise can improve the mastery level of fire emergency plan in operating room of operating room members. It is worthy of popularization and application in clinic.

Objective:To establish the best preventive measures for inadvertent perioperative hypothermia (IPH) in patients undergoing off-pump coronary artery bypass grafting (OPCABG) based on evidence, in order to reduce the incidence of IPH and reduce various complications in OPCABG patients.Methods:The evidence of preventive measures for IPH in OPCABG patients was systematically searched in major databases at home and abroad. The retrieval time limit was from the establishment of the database to August 31, 2019. Three researchers independently screened and evaluated the literature to obtain the best evidence for the prevention of IPH in patients with OPCABG. Using the cluster sampling method, 29 patients who underwent OPCABG in Zhejiang Provincial People's Hospital from January to April 2020 were selected as the control group, while 27 patients who underwent OPCABG from January to April 2021 were selected as the observation group. The differences in body temperature at admission, body temperature at 1 hour after anesthesia, body temperature after leaving the department, minimum intraoperative body temperature, drainage volume in the first 24 hours after surgery, length of stay in ICU and length of hospital stay after surgery were compared between the two groups.Results:A total of 17 papers were included, and 20 pieces of relevant evidence were obtained. After evaluation by experts, the best evidence suitable for the research environment was selected and applied in clinical practice. The body temperatures at admission of patients in the control group and the observation group were respectively (36.62±0.30) ℃ and (36.49±0.28) ℃, and the difference was not statistically significant ( t=2.85, P>0.05) . The body temperature at 1 h after anesthesia, the body temperature after leaving the department and the lowest body temperature during operation were (35.83±0.30) , (36.04±0.49) and (35.50±0.31) ℃ in the control group, and (36.43±0.38) , (36.62±0.27) and (36.21±0.28) ℃ in the observation group, respectively. The difference between the two groups were statistically significant ( t=37.65, 23.76, 58.13; P<0.01) . The incidence of IPH was 93.1% (27/29) in the control group and 11.1% (3/27) in the observation group, and the difference was statistically significant (χ 2=34.568, P<0.01) . The drainage volume in the first 24 h after operation in the control group was (260.0±70.3) ml and that in the observation group was (212.1±44.3) ml, and the difference between the two groups was statistically significant ( t=-3.025, P<0.01) . The length of ICU stay and hospital stay in the control group were respectively (49.0±13.4) h and (12.2±3.5) d, while those in the observation group were (39.8±13.8) h and (10.5±2.5) d, and the differences between the two groups were statistically significant ( t=-2.524, -2.035; P<0.05) . Conclusions:The best preventive measures for inadvertent perioperative hypothermia in patients with OPCABG provide scientific and rigorous procedures and specifications for the prevention of inadvertent perioperative hypothermia in this type of surgery, effectively reducing the incidence of inadvertent perioperative hypothermia and maintaining the intraoperative core temperature stability of patients, reduce postoperative bleeding and shorten the length of ICU stay and hospital stay, which is worthy of clinical promotion.