目的 探讨三级甲等医院急诊科体外心肺复苏团队标准化运行的困境，为完善标准化运行策略提供参考。 方法 采用现象学研究方法，于2025年10月—12月采用目的抽样法并遵循最大差异取样原则，选取江苏省某三级甲等医院急诊科参与实施体外心肺复苏术的18名医护人员进行半结构式访谈，采用Colaizzi 7步分析法分析资料。 结果 提炼出4个主题、11个子主题：高度时间压力与复杂情境下标准化流程难以完全落地；人力资源长期紧张，医护人员承受高负荷；培训体系重操作、轻系统，能力结构失衡；高风险、高成本决策情境下医护人员心理压力突出。 结论 三级甲等医院急诊体外心肺复苏团队标准化运行存在情境适配不足、多部门协作衔接不畅、人力与梯队保障不足、培训支持不完善及心理支持缺乏等现实挑战。医院在推进标准化运行时，应在现有技术规范基础上，进一步优化关键流程与用物准备，完善多部门协作与信息闭环机制，强化人力梯队建设和分层培训，重视医患沟通并将心理支持纳入团队建设，以提升流程可执行性与运行可持续性。

Objective To explore the practical dilemmas in the standardized operation of extracorporeal cardiopulmonary resuscitation（ECPR） team in the emergency department of a tertiary hospital，and to provide a reference for improving standardized operational strategies. Methods A phenomenological research method was adopted. From October to December 2025，18 physicians and nurses involved in ECPR implementation in the emergency department of a tertiary hospital in Jiangsu Province were selected by purposive sampling following the principle of maximum variation sampling for semi-structured interviews. Data were analyzed using Colaizzi’s seven-step method. Results Four themes and 11 subthemes were identified：difficulty in fully implementing standardized procedures under intense time pressure and complex situations；long-term shortage of human resources and heavy workload of medical staff；a training system emphasizing technical operation over systematic competence and an imbalanced competency structure；and prominent psychological stress among medical staff in high-risk，high-cost decision-making situations. Conclusion The standardized operation of emergency department ECPR teams in tertiary hospitals faces practical challenges，including insufficient adaptation to emergency contexts，poor coordination across multiple departments，inadequate staffing and team echelon support，insufficient training support，and lack of psychological support. In promoting standardized operation，hospitals should further optimize key procedures and equipment preparation on the basis of existing technical standards，improve multidisciplinary collaboration and closed-loop information mechanisms，strengthen workforce echelon development and tiered training，emphasize communication with patients and their families，and incorporate psychological support into team building，so as to enhance procedural executability and operational sustainability.