摘要
目的 评估深圳市院前急救与院内急诊科医师在劳力性热射病(EHS)的预防、诊断及管理方面的知识水平与临床实践现状,分析知识缺陷及临床实践问题。方法 采用描述性横断面调查设计,对深圳市249名从事院前急救及院内急诊医师进行问卷调查。问卷涵盖6个维度:人口学资料、EHS基础知识与流行病学、诊断与评估、现场与院内管理、并发症及预防策略。采用描述性统计分析方法,识别知识与实践的缺陷。结果 受访者对EHS的严重性[正确率97.59%(243/249)]和核心病理生理学[正确率93.98%(234/249)]认知较高,但在热适应机制[正确率44.58%(111/249)]及精确诊断标准[多选题全选正确率仅12.45%(31/249)]等领域存在显著知识缺陷。理论认知与临床实践之间存在明显差距:91.16%(227/249)的受访者知晓直肠测温是核心体温测量的最佳方法,但仅2.81%(7/249)在实践中应用;27.71%(69/249)的受访者知晓冷水浸泡是首选降温方式,但90.36%(225/249)从未采用浴缸浸泡,仅1.61%(4/249)将其作为主要降温方法。此外,降温资源准备不足[仅49.40%(123/249)报告物资充足],46.59%(116/249)的受访者近期未系统学习EHS相关指南,60.64%(151/249)自评其EHS管理水平为“一般”。结论 深圳市院前与急诊医师在EHS防治中存在显著的知识缺陷与“知行鸿沟”,表现为对有效降温策略的理解不足、关键设备缺乏以及指南依从性欠佳,这些问题可能对患者预后产生不利影响。亟需通过针对性教育、优化资源配置及强化指南实施,提升EHS救治水平。
Objective To assess the knowledge level and clinical practice status of prehospital and emergency physicians in Shenzhen regarding the prevention,diagnosis,and management of exertional heat stroke(EHS),and to identify knowledge deficits and discrepancies between theoretical understanding and practical application.Methods A descriptive cross-sectional survey was conducted among 249 physicians working in prehospital emergency care,and emergency departments(ED)in Shenzhen.The questionnaire encompassed six dimensions:demographic information,basic knowledge and epidemiology of EHS,diagnosis and assessment,on-site and in-hospital management,complications,and prevention strategies.Descriptive statistical analysis was employed to identify gaps in knowledge and practice.Results Respondents demonstrated high awareness of EHS severity[correct response rate:97.59%(243/249)]and core pathophysiology[93.98%(234/249)].However,significant knowledge deficits were observed in areas such as heat acclimation mechanisms[correct response rate:44.58%(111/249)]and precise diagnostic criteria[only 12.45%(31/249)correctly answered all items in multiple-choice questions].Notable discrepancies existed between theoretical knowledge and clinical practice,particularly in core temperature measurement[91.16%(227/249)recognized rectal thermometry as the optimal method,but only 2.81%applied it in practice]and cooling techniques[27.71%(69/249)identified cold water immersion as the preferred method,yet 90.36%(225/249)never used bathtub immersion,and only 1.61%(4/249)adopted it as the primary approach].Furthermore,cooling resources were inadequate,with only 49.40%(123/249)of respondents reporting sufficient supplies.Additionally,46.59%(116/249)of respondents had not systematically reviewed EHS-related guidelines recently,and 60.64%(151/249)self-assessed their EHS management proficiency as"average".Conclusion Prehospital and emergency physicians in Shenzhen exhibit significant knowledge deficits and a pronounced"knowledge-practice gap"in EHS prevention and management.These gaps are characterized by a limited understanding of effective cooling strategies,inadequate availability of critical equipment,and suboptimal adherence to evidence-based guidelines,which may adversely affect patient outcomes.Urgent interventions,including targeted education,resource optimization,and implementation of standardized protocols,are essential to enhance EHS care.
作者
朱虹
桂见军
郑广新
ZHU Hong;GUI Jianjun;ZHENG Guangxin(Shenzhen Emergency Medical Center,Shenzhen Guangdong 518108,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第12期1665-1668,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
劳力性热射病
知识差距
实践差距
急诊医学
院前急救
病死率
冷水浸泡
Exertional heat stroke
Knowledge gap
Practice gap
Emergency medicine
Pre-hospital first aid
Case fatality rate
Cold water immersion
