Medical Behavior in Cardiorespiratory Arrest before and After Simulation Based on Advanced Cardiac Life Support (ACLS) Course

Abstract Background: The Advanced Cardiac Life Support (ACLS) course is designed to teach cardiovascular emergency, aiming to promote a harmonious and synchronized work of the entire hospital team, making the multidisciplinary job more effective in the execution of cardiopulmonary resuscitation (CPR). Objective: To compare the effectiveness of CPR performed between physicians trained on ACLS and non-trained physicians. Methods: A questionnaire was applied to physicians working at the emergency room of hospitals in Curitiba, state of Paraná, whose resolution required theoretical and practical knowledge about CPR. For analysis, descriptive statistics and Fisher's association analysis were used, and the medians of the groups were evaluated by Mann-Whitney/Kruskal-Wallis with significance of 5%. Results: Thirty-four physicians were volunteers, of whom 20 had taken the ACLS course (Group A) and 14 had not (Group B). The trained physicians obtained the highest median (4.00 vs. 3.00, p = 0.06) of correct answers. Group A scored at least 3 of the 5 questions in the questionnaire, showing better performance than Group B (OR = 6.75, 95% CI, 1.1 &lt; OR &lt; 41.0, p = 0.04). The year of the course did not significantly change the performance in the questionnaire. Conclusion: It is suggested that the ACLS course was effective in qualifying physicians to handle situations of cardiorespiratory arrest properly, which was reproduced by the better performance in the resolution of the questionnaire. It is believed that when the sample of volunteers is increased, the trends found materialize the other hypotheses proposed.研究背景：高级心血管生命支持（Advanced Cardiac Life Support, ACLS）课程旨在传授心血管急症救治知识，推动全院团队实现协调同步的协作，使多学科团队在实施心肺复苏（cardiopulmonary resuscitation, CPR）时的工作更为高效。 研究目的：对比接受ACLS培训的医师与未接受培训的医师实施心肺复苏的效果。 研究方法：向巴西巴拉那州库里蒂巴市各医院急诊室的在职医师发放问卷，该问卷的作答需具备心肺复苏相关的理论与实践知识。数据分析采用描述性统计与Fisher关联分析，组间中位数比较采用Mann-Whitney/Kruskal-Wallis检验，显著性水平设定为5%。 研究结果：共有34名医师作为志愿者参与本研究，其中20名完成ACLS培训（A组），14名未参加相关培训（B组）。接受培训的医师答对题目的中位数更高（4.00 vs. 3.00，p=0.06）。A组在问卷的5道题目中至少答对3道，整体表现优于B组（优势比[OR]=6.75，95%置信区间[CI]：1.1 < OR < 41.0，p=0.04）。培训年份对问卷作答成绩无显著影响。 研究结论：本研究提示，ACLS培训可有效使医师具备正确处置心搏骤停相关事件的能力，这一结论通过其在问卷作答中的优异表现得到验证。研究认为，若扩大志愿者样本量，本研究发现的趋势将验证其余提出的研究假设。