目的 探讨在全院范围内开展严重过敏反应发展至心搏骤停的原位模拟实施效果。方法 依据最佳模拟教学实践标准，构建严重过敏反应发展至心搏骤停的原位模拟实施方案，2022年11月—2023年2月，在浙江省三级甲等儿童专科医院进行未经通知的原位模拟，整理分析出确定安全隐患，同时采用问卷对实施效果进行评价。 结果 在全院各科室共进行了31次原位模拟，识别出55个安全隐患。参与案例运行的护士对整体实施方案的评分为91（82，96）分。结论 原位模拟可实时识别临床环境中的安全隐患，参与者较为认可原位模拟的方法、内容及组织安排。

Objective To explore the implementation outcomes of in-situ simulation for severe allergic reactions progressing to cardiac arrest across a hospital. Methods Based on best practices in simulation teaching，an in-situ simulation implementation plan was developed for severe allergic reactions leading to cardiac arrest. From November 2022 to February 2023，unannounced in-situ simulations were conducted at a tertiary-level children’s hospital in Zhejiang Province. Safety hazards were identified and analyzed，and a questionnaires were used to evaluate the implementation outcomes. Results A total of 31 in-situ simulations were conducted across the hospital，identifying 55 safety hazards. Nurses participating in the case scenarios rated the overall implementation plan at 91 （82，96） points. Conclusion In-situ simulation can effectively identify safety hazards in clinical environments，and participants generally acknowledge the value of its methods，content，and organizational structure..