Objective:To explore an initial target rate for resuscitation attempted by bystanders for patients experiencing out-of-hospital cardiac arrest in China.Methods:We searched seven electronic databases, including CNKI, VIP, Wanfang, CBM, PubMed, Cochrane, EMBase, for Utstein-style reports of out-of-hospital cardiac arrest, containing data on bystander resuscitation and survival to discharge or 30 days after arrest. All patients with cardiac arrest diagnosed at prehospital emergency medical services were included. Meta-analysis was performed to pool rate ratios (RR) with 95% confidence intervals (CI) of the rate of survival to discharge or 30 days. The population attributable risk percent (PARP) was calculated with RR, and the growth rate curve of PARP following bystander cardiopulmonary resuscitation rate was plotted. We established a multiple linear regression model to show the change in survival to discharge or 30 days with increasing rates of resuscitation attempted by bystanders.Results:We included 24 cohorts with 279 641 patients experiencing out-of-hospital cardiac arrest. The median rates of bystander cardiopulmonary resuscitation and survival to discharge or 30 days after arrest in seven cohorts from China were 2.8% and 0.47%, respectively, both far below the first tertiles in all cohorts worldwide (10.0% and 2.70%, respectively). The meta-analysis showed that resuscitation attempts by bystanders increased the chance of survival to discharge or 30 days ( RR=5.91, 95% CI 3.28-10.66; I2=0, P=0.990). The growth rate curve on PARP showed a rapid attenuation in the increase of PARP after the bystander resuscitation rate reached 10%. The multiple linear regression showed that resuscitation attempted by bystanders could explain 74.4% of the variation in the rates of survival to discharge or 30 days. By increasing the bystander resuscitation rate to 10%, the rate of survival to discharge or 30 days could increase to 1.40% (95% CI 0.76%-2.05%), and the PARP could increase from 19.7% to 32.9%. Conclusions:Low rate of resuscitation attempted by bystanders is currently the main reason for the poor survival rate of out-of-hospital cardiac arrest in China. It is recommended to increase the rate of resuscitation attempted by bystanders in stages with an initial target rate of 10%.

Objective:To explore an initial target rate for resuscitation attempted by bystanders for patients experiencing out-of-hospital cardiac arrest in China.Methods:We searched seven electronic databases, including CNKI, VIP, Wanfang, CBM, PubMed, Cochrane, EMBase, for Utstein-style reports of out-of-hospital cardiac arrest, containing data on bystander resuscitation and survival to discharge or 30 days after arrest. All patients with cardiac arrest diagnosed at prehospital emergency medical services were included. Meta-analysis was performed to pool rate ratios (RR) with 95% confidence intervals (CI) of the rate of survival to discharge or 30 days. The population attributable risk percent (PARP) was calculated with RR, and the growth rate curve of PARP following bystander cardiopulmonary resuscitation rate was plotted. We established a multiple linear regression model to show the change in survival to discharge or 30 days with increasing rates of resuscitation attempted by bystanders.Results:We included 24 cohorts with 279 641 patients experiencing out-of-hospital cardiac arrest. The median rates of bystander cardiopulmonary resuscitation and survival to discharge or 30 days after arrest in seven cohorts from China were 2.8% and 0.47%, respectively, both far below the first tertiles in all cohorts worldwide (10.0% and 2.70%, respectively). The meta-analysis showed that resuscitation attempts by bystanders increased the chance of survival to discharge or 30 days ( RR=5.91, 95% CI 3.28-10.66; I2=0, P=0.990). The growth rate curve on PARP showed a rapid attenuation in the increase of PARP after the bystander resuscitation rate reached 10%. The multiple linear regression showed that resuscitation attempted by bystanders could explain 74.4% of the variation in the rates of survival to discharge or 30 days. By increasing the bystander resuscitation rate to 10%, the rate of survival to discharge or 30 days could increase to 1.40% (95% CI 0.76%-2.05%), and the PARP could increase from 19.7% to 32.9%. Conclusions:Low rate of resuscitation attempted by bystanders is currently the main reason for the poor survival rate of out-of-hospital cardiac arrest in China. It is recommended to increase the rate of resuscitation attempted by bystanders in stages with an initial target rate of 10%.

Objective? To explore the effects of "micro-courses+flipped classroom+pathway" model in standardized training for emergency nurses. Methods? From January 2017 to December 2018, we selected 97 nurses attending standardized training in Emergency Department of Mianyang Central Hospital as subjects by convenience sampling. A total of 50 nurses attending training in 2017 were set in control group; 47 nurses attending training in 2018 were set in experimental group. Control group made teaching plan, teaching one-to-one, according to the requirements of "Training Program for New Recruiting Nurse" of National Health and Family Planning Commission. Nurses of experimental group received "micro-courses + flipped classroom+ pathway" model. We compared the theoretical achievements and operation achievements of nurses out of department between two groups, and the Adult Learning Satisfaction Scale and Self-rating Scale of Self-directed Learning (SRSSDL) were used to compare nurses' satisfaction and learning ability. Results? The theoretical achievements and operation achievements of nurses out of department in experimental group were (79.23±8.99) and (85.23±8.70) respectively higher than those [(73.58±8.14) and (75.66±8.61)]in control group with statistical differences (t=5.351, 5.187; P＜0.01). The total score of the Adult Learning Satisfaction Scale and SRSSDL were (17.16±0.81) and (225.36±23.05) respectively higher than those in control group with statistical differences (t=2.683, 7.683;P＜ 0.05). Conclusions? The "micro-courses + flipped classroom + pathway"model suits the teaching for emergency nurses attending standardized training which can improve learning satisfaction and self-directed learning ability of nurses attending standardized training.

Objective To explore effects of pre-hospital and in-hospital linkage of emergency department in earthquake rescue. Methods After earthquake occurred to Jiuzhaigou, pre-hospital rescuers divided the work reasonably, determined the wounded according to injury condition and transferred them by batch, coordinated ambulances, transmitted accurate information related to rescue and the wounded transported later in time. Emergency department of hospital linked with the first line, reasonably distributed and assigned health care providers based on the batches and numbers of the wounded transported later as well as made the green channel for the wounded of earthquake unobstructed. Results It was completed within one hour from headquarters instructed to health care providers transported 34 injured patients later by batch and 29 ambulances started. All of the wounded were safe and ordered, and then they were arranged without secondary injury. From emergency department received the wounded to the wounded were sent to the ward, the wounds were checked again for 53 times in emergency department, the checks were carried out for 142 times with average consumed time of (23.5±11.5) min. Conclusions The pre-hospital and in-hospital linkage of emergency department can effectively shorten the time of transportation and arrangement for the wound. Health care providers of emergency department play a leading and link role in the earlier stage of emergency relief.

Objective To investigate the application of field work logs in collection of the disaster information in medical rescue of earthquake.Methods The self-designed work logs were made according to the condition of the wounded in the medical rescue of Lushan earthquake.Through the field work logs,we got first hand information which facilitate statistics,inquiry and subsequent follow-up work.Results By using the field work logs,the rescue workers guaranteed the collection of original data timely and accurately,supplied a number of rich and a-list clinical data and also facilitated the masses in disaster areas looking for their relatives.Conclusions The application of field work logs played a pivotal role in medical rescue of Lushan earthquake.It can be widely extended as a general manner in emergency disaster rescue after further perfection.