目的   探讨基于思维导图的绿色通道急救干预对急性心肌梗死患者介入治疗的效果。方法   对天津市人民医院2022年1月—2024年12月收治的80例AMI患者进行研究，依照收治时间进行分组，将2022年1月—2023年6月采取常规急救流程干预的40例患者分为常规组，将2023年7月—2024年12月的采取基于思维导图的绿色通道急救干预的40例患者分为思维导图组。比较两组患者急救效率、急救前后生命体征（心率、舒张压、收缩压）、心肌损伤指标［磷酸肌酸激酶（CK-MB）及肌钙蛋白Ⅰ（cTnI）］，最后比较两组患者干预满意度。结果   对比急救效率发现，思维导图组的预检时间、会诊时间、导管室激活时间、急诊送至PCI手术时间均短于常规组（P＜0.05）；对比急救前后生命体征发现，与急救前对比，急救后两组的心率、舒张压、收缩压均降低（P＜0.05），急救前后两组心率、舒张压、收缩压比较差异无统计学意义（P＞0.05）；对比急救前后心肌损伤指标发现，急救前两组CK-MB、cTnI比较差异无统计学意义（P＞0.05），急救后，思维导图组CK-MB、cTnI低于常规组与急救前（P＜0.05）；对比干预满意度发现，思维导图组干预满意度为100.00%，高于常规组的85.00%（P＜0.05）。结论  基于思维导图的绿色通道急救干预可提升AMI患者的急救效率，稳定患者生命体征，减轻心肌损伤的同时，提升患者干预满意度。

       Objective  To explore the effect of green channel emergency nursing based on mind mapping on percutaneous coronary intervention（PCI） of patients with acute myocardial infarction（AMI）．Methods  A study was conducted on 80 AMI patients admitted to Tianjin People’s Hospital from January 2022 to December 2024．The patients were divided into two groups based on their admission time．The 40 patients who received routine emergency nursing interventions from January 2021 to June 2023 were assigned to the conventional group，while the 40 patients who  received green channel emergency nursing based on mind mapping from July 2023 to November 2024 were assigned to the mind mapping group．The emergency treatment efficacy，vital signs（heart rate，diastolic blood pressure，systolic bloodpressure），myocardial injury indicators（phosphocreatine kinase［CK-MB］，and troponin I［cTn1］）between two groups of patients before and after emergency treatment were compared．Results  The pre-examination time，consultation time，catheterization room activation time and emergency room to PCI operation time of mind mapping group were all shorter than those of conventional group（P＜0.05）．Compared with the vital signs before and after emergency treatment，we found that the heart rate，diastolic pressure and systolic blood pressure of the two groups decreased after emergency treatment（P＜0.05），and there was no significant difference between the heart rate，diastolic pressure and systolic blood pressure of the two groups before and after emergency treatment（P＞0.05）．Comparing the myocardial injury indicators before and after emergency treatment，there was no significant difference in CK-MB and cTn1 between the two groups before emergency treatment（P＞0.05）．After emergency treatment，CK-MB and cTn1 in the mind map group were lower than those in the conventional group and before emergency treatment（P＜0.05）．Comparing the intervention satisfaction，it was found that the mind mapping group of 100.00% was higher than the conventional group of 85.00%（P＜0.05）．Conclusions  Green channel emergency nursing based on mind mapping can improve the efficiency of emergency treatment for AMI patients，stabilize their vital signs，reduce myocardial injury，improve patient intervention satisfaction．

目的 探讨BOPPPS[（导引（B）,目标（O）,课前测试（P）,参与式学习（P）,课后测试（P）,总结（S）]模式下模块化教学结合模拟演练在创伤急救培训中的应用效果。方法 选取福建省泉州市正骨医院急诊科2022年8月—2024年2月90名护士,随机分为对照组和干预组,每组45名护士。对照组采用传统授课模式进行教学培训;干预组采用BOPPPS模式下模块化教学结合模拟演练进行教学培训。培训结束对两组学员的创伤急救综合理论及单项技能、创伤急救救护综合能力、培训效果满意度进行统计分析。结果 干预组的综合理论成绩为（80.74±6.87）分、单项技能成绩为（92.13±2.26）分,相较于对照组均提高（P<0.05）。干预组对创伤急救课程的总体满意度：非常同意23例、同意20例,比例均高于对照组（P<0.05）。干预组的创伤急救救护综合能力如病情评估预判能力,优秀26例、良好15例;护理计划分析实施能力,优秀25例、良好13例;团队协作与资源管理能力,优秀27例、良好15例;情景感知与应变能力,优秀30例、良好11例;综合救护能力,优秀36例、良好5例。显著优于对照组（P<0.05）。结论 BOPPPS模式下模块化教学结合模拟演练能够提高急诊科护士的综合创伤救护能力,且取得了较高的满意度,值得进一步推广应用。

Objective To explore the application effect of modular teaching combined with simulation exercise in trauma first aid training under BOPPPS model．Methods A total of 90 nurses in the emergency department from August 2022 to February 2024 were randomly divided into control group（n=45） and intervention group（n=45）．The control group was trained by traditional teaching mode．The intervention group was trained by BOPPPS modular teaching combined with simulation exercise．After the training,the comprehensive theory of trauma first aid,individual skills,comprehensive ability of trauma first aid and satisfaction degree of training effect of the two groups of nurses were statistically analyzed．Results The comprehensive theoretical scores and single skill scores of the intervention group were significantly improved compared with the control group（P<0.05）．The satisfaction degree of trauma first aid training in the intervention group was significantly higher than that in the control group（P<0.05）．The comprehensive ability of trauma first aid in the intervention group was significantly better than that in the control group（P<0.05）．Conclusions The combination of modular teaching and simulation exercise in BOPPPS model can improve the comprehensive trauma rescue ability of nurses in emergency department,and has obtained a high degree of satisfaction,which is worthy of further popularization and application．

目的 探讨系统化护理流程干预对脑出血患者急救效果及预后的影响。方法 采用回顾性分析的方法,选取2022年2月—2023年2月新乡医学院第三附属医院急诊收治的210例脑出血患者,将2022年2月—2022年8月采取常规护理干预的105例患者作为常规组,将2022年9月—2023年2月采取系统化护理流程干预的105例患者作为研究组。对比两组患者抢救效率、急救效果、并发症发生率、预后水平、护理满意度情况。结果 研究组患者抢救总时间、会诊至确诊、分诊至会诊、接诊至分诊以及出诊反应时间短于常规组（P<0.05）;研究组急救总有效率高于常规组,并发症发生率低于常规组（P<0.05）;出院1个月、3个月后,两组患者神经功能缺损量表（NIHSS）评分均降低,简易智能状态检查量表（MMSE）评分升高,研究组变化幅度更大（P<0.05）;研究组患者护理满意度高于常规组（P<0.05）。结论 针对脑出血患者在急救过程中采取系统化护理流程干预能够提升患者的抢救效率和急救效果,并发症发生率低,改善患者的神经功能缺损情况,提升预后水平,且患者满意度较高。

Objective To explore the impact of systematic nursing process intervention on the emergency response and prognosis of patients with cerebral hemorrhage．Methods By retrospective analysis,210 patients with cerebral hemorrhage admitted to the emergency department of the Third Affiliated Hospital of Xinxiang Medical College from February 2022 to February 2023,105 patients with routine nursing intervention from February 2022 to August 2022 were selected as the routine group,and 105 patients with systematic nursing process intervention from September 2022 to February 2023 were selected as the study group．The rescue efficiency,first aid effect,complication rate,prognosis levels and nursing satisfaction of the two groups were compared．Results The total rescue time,consultation to diagnosis,triage to consultation,reception to triage and the response time to visit in the study group were significantly lower（P<0.05）．The total emergency response rate of the study group was higher than that of the conventional group,and the incidence of complications was significantly lower（P<0.05）．One month and 3 months after discharge,NIHSS score decreased in both groups,MMSE score increased,and the change range was greater in the study group（P<0.05）．The nursing satisfaction of the study group was significantly higher（P<0.05）．Conclusions For patients with cerebral hemorrhage,systematic nursing process intervention in the first aid process can improve the rescue efficiency and first aid effect of patients,reduce the incidence of complications,improve the neurological function defect of patients,improve the prognosis level,and the patient satisfaction is higher．

目的 分析华北地区某医院院前急救医疗服务的资源利用状况,并依据相关影响因素针对院前急救医疗服务过程中存在问题提出相应对策。方法 收集2021年3月—2022年4月期间就诊于华北地区某医院急诊科患者的一般资料、就诊过程、症状特征。依据是否接受过院前急救服务、是否为疾病急性发作的危重症患者将患者分为4组,分析比较4组患者在一般资料、疾病病症特点两个方面是否存在统计学差异,探索影响院前急救医疗资源合理利用的相关因素。结果 本研究总计收纳患者病例5 800例,其中接受院前急救医疗服务的患者共840例占总调查人数的14.5%,其中危重症患者530例（63.1%）,非危重症患者310例（36.9%）;未接受院前急救医疗服务的患者为4 960例占总调查人数的85.5%,其中危重症患者803例（16.2%）。对所得数据采用多因素回归方法分析得知,在急诊科接受的危重症患者中急性胸痛与突发性头痛是选择不使用院前急救医疗措施的独立影响因素。在非危重症患者中发热、外伤、腹痛是非急重症患者接受院前急救医疗服务的独立影响因素。结论 院前急救医疗服务资源的提供与利用在实际应用的过程中存在资源闲置与服务空缺的问题。危重症患者在入院前仍有较大比例的患者没有选择接受院前急救医疗服务。该情况表明当前居民对危重症患者危重症状及院前急救医疗服务了解与认知不足,对此有必要加强对居民关于院前急救服务的科普宣教工作,并借助现有医疗服务力量支持院前急救医疗服务的规范与准则,这对保障患者生命安全,争取危重症患者存活机会,促进急救资源合理利用具有重要意义。

Objective To analyze the resource utilization status of pre-hospital emergency medical services in a hospital in North China,and to propose corresponding countermeasures for problems in the process of pre-hospital emergency medical services according to relevant influencing factors．Methods From March 2021 to April 2022,the general data,treatment process and symptom characteristics of patients who were treated in the emergency department of a hospital in North China were collected．According to whether they had received pre-hospital emergency services and whether they were critically ill patients with acute onset of disease,the patients were divided into four groups．Whether there were statistical differences in the general data and disease characteristics of the four groups of patients,and the relevant factors affecting the rational utilization of pre-hospital emergency medical resources were explored．Results This study included 5 800 patients,of which 840 patients receiving pre-hospital emergency medical services,accounted for 14.5% of the total survey,including 530（63.1%）and 310 non-critically ill patients（36.9%）;4 960 patients not receiving pre-hospital emergency medical services accounted for 85.5% of the total survey,including 803（16.2%）of critically ill patients．Analysis by multivariate regression methods on the obtained data showed that acute chest pain and sudden headache in critically ill patients in the emergency department were independent influencing factors in choosing not to use pre-hospital emergency medical measures．Fever,trauma,and abdominal pain in non-critically ill patients were independent factors influencing the reception of pre-hospital emergency medical services．Conclusions The provision and utilization of pre-hospital emergency medical service resources have the problem of idle resources and service vacancies in the process of practical application．A significant proportion of critically ill patients still do not choose to receive pre-hospital emergency medical services before admission．This situation shows that the current residents have insufficient understanding and cognition of critical symptoms and pre-hospital emergency medical services,and it is necessary to strengthen the scientific popularization and education of residents on pre-hospital emergency services,and support the norms and guidelines of pre-hospital emergency medical services with the help of existed medical services,which is of great significance for ensuring the safety of patients' lives,striving for the survival opportunities of critically ill patients,and promoting the rational use of emergency resources．

目的 探讨良肢位训练联合风险预控急救应用于重症脑卒中的效果。方法 采用回顾性分析,纳入我院2020年3月—2021年3月期间收治的41例重症脑卒中患者为对照组,救治方式为常规救治联合良肢位训练。同时纳入我院2021年4月—2022年4月期间收治的41例重症脑卒中患者为观察组,救治方式为良肢位训练联合风险预控急救。对比2组抢救情况、抢救效果、运动功能。结果 观察组院外吸氧率（46.34%）、院外插管率（34.15%）均高于对照组（17.07%、9.76%）,转入专科治疗时间、发病至入院时间均短于对照组（P<0.05）;干预3 d后,观察组格拉斯哥昏迷量表分值高于对照组,APACHEⅡ评分分值低于对照组（P<0.05）;观察组Fugl-Meyer运动评估、Berg平衡量表分值均高于对照组,NIHSS量表分值低于对照组（P<0.05）。结论 良肢位训练联合风险预控急救应用于重症脑卒中可有效改善抢救情况、提升抢救效果,从而增强运动功能。

Objective To explore the effect of normal extremity position training combined with risk pre-control emergency treatment in severe stroke．Methods Forty-one severe stroke patients from March 2020 to March 2021 included in the control group were retrospective studied,and the treatment method was conventional treatment combined with normal extremity position training．At the same time,41 severe stroke patients from April 2021 to April 2022 were included in the observation group,which the treatment method was the risk pre-control and emergency treatment．The rescue situation,rescue effect and sports function of the two groups were compared．Results Incidences of oxygen inhalation（46.34%）and intubation（34.15%）outside the hospital in observation group were higher than that in control group（17.07%,9.76%）;specialist treatment,onset to admission time were longer in control group（P<0.05）．Glasgow coma scale score in observation group was higher than that in control group,while APACHE Ⅱ score was lower in observation group（P<0.05）,Fugl-Meyer assessment and Berg Balance Scale score were higher,and NIHSS score was lower than control group（P<0.05）．Conclusions Combination of normal extremity position training and risk pre-control emergency treatment in severe stroke treatment can effectively improve the rescue effect,thus enhance the motor function．

目的 调查口腔专科医院门诊不同层级护士急救能力的现状,进一步探讨优化口腔门诊护士急救培训模式。方法 选取2019年1月—2020年1月我院口腔门诊护士97名,采用自设问卷调查及现场操作技能评估对护士进行考核,调查护士的急救能力。结果 口腔科门诊不同层级护士的急救能力(包括相关知识与操作能力)差异有统计学意义(P＜0.05)。其中,N1级(工作1~＜3年)的护理人员急救能力低于N2级(工作3~5年)的护理人员。N3级(工作6~10年)的急救知识考核分、操作考核分略低于工作N2级护士,但差异无统计学意义。而不同年龄、学历、职称、科室的护士急救能力的差异无统计学意义。结论 口腔门诊护士急救培训应分层级进行,特别应加强N1级以下护理人员的急救技能培训,保证护士急救培训效果同质化,对口腔门诊诊疗中提高医疗安全及护理质量具有重要意义。

Objective To investigate the current status of the first-aid ability of nurses at different levels in outpatient clinics of stomatological hospitals, and to further explore the optimization of the training model of first-aid nurses in outpatient clinics. Methods A total of 97 nurses in our outpatient clinic from January 2019 to January 2020 were selected. The nurses were assessed by self-designed questionnaire surveys and on-site operation skills assessment to investigate the nurses' first aid ability. Results The difference in first aid ability (including relevant knowledge and operation ability) of nurses at different levels in the dental clinic was statistically significant (P<0.05). Among them, the first-aid ability of nursing staff of N1 grade (working 1 ~<3 years) is lower than that of nursing staff of N2 grade (working 3 ~ 5 years). The N3 level (working 6～10 years) first aid knowledge assessment and operation assessment scores are slightly lower than those of working N2 nurses, but the difference is not statistically significant. There was no statistically significant difference in the first aid ability in nurses of different ages, educational backgrounds, titles, and departments. Conclusion The first-aid training of nurses in oral clinics should be conducted in different levels, especially the first-aid skills training of nurses below N1 level. We should be strengthened to ensure the homogenization of nurse's first-aid training effect, which is of great significance to improve medical safety and quality of care in oral clinics.

目的 探讨市区院前急救流行病学特征,为制定院前急救策略和合理调配急救资源提供参考依据。方法 采用回顾性资料收集方法选取我院2013—2014年院前急救患者14000例(对照组),2017年院前急救患者9 630例(观察组)作为研究对象,对两组的性别、年龄、死亡原因等建立数据库,采用描述性研究和圆形分布方法进行统计分析,并对比两组数据,分析院前急救患者变化趋势。结果 对照组急救患者性别男性所占比例高于女性,年龄45~55岁所占比例最高,死亡原因创伤所占比例最高,心脑血管疾病其次;观察组急救患者性别男性所占比例高于女性,但低于对照组男性所占比例,年龄45~55岁所占比例最高,但比例低于对照组,死亡原因创伤所占比例最高,心脑血管疾病其次。结论 根据院前急救时间分布规律合理调配急救资源,充分发挥院前急救功能,提高院前急救水平。

目的 探讨精神科急救培训用护士作为标准化病人的培养方法。方法 2013年9月挑选了4名精神科护士参加标准化病人系统培训,考核合格后成为护士标准化病人在2013年10月—11月对30名新护士自缢、噎食急救培训和考核中使用。结果 对急救培训中使用护士标准化病人,30名新护士中认为“新颖,第一次接触”19人(63%)、“满意”的26人(87%);4名作为标准化病人的护士都认为“非常有意义”。结论 精神科急救培训应用护士标准化病人丰富了培训的形式和内涵,得到了绝大部分参与人员的肯定。

Objective To explore the methods of training nurses as standardized patients for psychiatric first aid. Methods 4 nurses were selected to participate in the psychiatric standardized patient training program and all passed the examination. Using these nurse standardized patients to train the 30 new nurses for psychiatric first aid. Results After the first aid training, 19 of the 30 new nurses(63%) felt that it was “novelty and interesting”. 26 nurses(87%) felt “being satisfied”. And those 4 standardized patients felt “very meaningful”. Conclusion Training and application of nurses as standardized patients for psychiatric first aid may enrich the form and content of training program, and gains most of the participants affirmation.

目的 调查公众急救培训普及现状及培训需求相关信息,并结合对院前急救工作及急救培训工作等经验的总结与思考,展开对急救培训普及工作的探讨,以指导我国急救培训工作的进一步开展与推广。方法 采用分层随机抽样法,对本市477名市民进行问卷调查。结果 425人(89.1%)认为在18周岁以前就需要掌握基本的急救知识;如无法律保障,原本愿意救援的市民299人中有117人(39.1%)选择放弃施救;最为认同的教学方法是模拟及角色扮演;最希望通过急救培训获得在突发意外灾害事件中正确有效的自救互救能力。结论 普及基本急救知识是城市或区域初级保健的一项重要内容,而目前普及率极低,市民需求迫切,呼吁各级政府及相关的公共服务部门要有计划地多方位、多渠道地组织市民进行内容丰富、形式多样急救培训。

       目的   探讨BOPPPS［（导引（B），目标（O），课前测试（P），参与式学习（P），课后测试（P），总结（S）］模式下模块化教学结合模拟演练在创伤急救培训中的应用效果。方法   选取福建省泉州市正骨医院急诊科2022年8月—2024年2月90名护士，随机分为对照组和干预组，每组45名护士。对照组采用传统授课模式进行教学培训；干预组采用BOPPPS模式下模块化教学结合模拟演练进行教学培训。培训结束对两组学员的创伤急救综合理论及单项技能、创伤急救救护综合能力、培训效果满意度进行统计分析。结果   干预组的综合理论成绩为（80.74±6.87）分、单项技能成绩为（92.13±2.26）分，相较于对照组均提高（P＜0.05）。干预组对创伤急救课程的总体满意度：非常同意23例、同意20例，比例均高于对照组（P＜0.05）。干预组的创伤急救救护综合能力如病情评估预判能力，优秀26例、良好15例；护理计划分析实施能力，优秀25例、良好13例；团队协作与资源管理能力，优秀27例、良好15例；情景感知与应变能力，优秀30例、良好11例；综合救护能力，优秀36例、良好5例。显著优于对照组（P＜0.05）。结论  BOPPPS模式下模块化教学结合模拟演练能够提高急诊科护士的综合创伤救护能力，且取得了较高的满意度，值得进一步推广应用。

       Objective  To explore the application effect of modular teaching combined with simulation exercise in trauma 

first aid training under BOPPPS model．Methods  A total of 90 nurses in the emergency department from August 2022 to February 2024 were randomly divided into control group（n=45） and intervention group（n=45）．The control group was trained  by traditional teaching mode．The intervention group was trained by BOPPPS modular teaching combined with simulation exercise．After the training，the comprehensive theory of trauma first aid，individual skills，comprehensive ability of trauma first aid and satisfaction degree of training effect of the two groups of nurses were statistically analyzed．Results  The comprehensive theoretical scores and single skill scores of the intervention group were significantly improved compared with the control group（P＜0.05）．The satisfaction degree of trauma first aid training in the intervention group was significantly higher than that in the control group（P＜0.05）．The comprehensive ability of trauma first aid in the intervention group was significantly better than that in the control group（P＜0.05）．Conclusions  The combination of modular teaching and  simulation exercise in BOPPPS model can improve the comprehensive trauma rescue ability of nurses in emergencydepartment，and has obtained a high degree of satisfaction，which is worthy of further popularization and application．