Kelley S P, McMurray D H M, Hinsche A F, Deacon P
Department of Orthopaedic Surgery, Mid Yorkshire Hospitals NHS Trust, Wakefield, Yorkshire, UK.
Ann R Coll Surg Engl. 2005 Jan;87(1):41-4. doi: 10.1308/1478708051478.
In 1993, the Major Trauma Working Group of Yorkshire proposed that hospitals should be accredited as Trauma Reception Hospitals with a policy for the response to the arrival of a trauma patient. These requirements include specific criteria for orthopaedics.
To evaluate if these criteria are being fulfilled, we carried out an audit comparing the response in the hospitals within the Yorkshire deanery to the arrival of major trauma. All consultant and middle-grade orthopaedic surgeons on call for trauma were contacted and questioned as to their ATLS provider status and involvement in the "trauma call".
16 hospitals were included of which 13 have a "trauma team". 191 surgeons (96% response) were included. 175 have completed an ATLS course. Of these, 72 (41%) had out-of-date qualifications. Only 9 (13%) were waiting to revalidate. Variation was seen in the frequency of accident and emergency department attendance by different grades of surgeon for major trauma.
All hospitals have a response for major trauma although variations occur. The vast majority of orthopaedic surgeons in Yorkshire have been adequately trained in ATLS management (more so than any study has previously shown), particularly the middle grades, who are usually first to attend. The level of revalidation is low and reasons for this are discussed with recommendations for revalidation in the future.
1993年,约克郡重大创伤工作组提议,医院应被认证为创伤接收医院,并制定应对创伤患者到来的政策。这些要求包括针对骨科的具体标准。
为评估这些标准是否得到满足,我们进行了一项审计,比较了约克郡地区医院对重大创伤患者到来的反应。我们联系了所有负责创伤急救的顾问级和中级骨科外科医生,询问他们的高级创伤生命支持(ATLS)提供者身份以及参与“创伤呼叫”的情况。
纳入了16家医院,其中13家有“创伤团队”。纳入了191名外科医生(回复率96%)。175人完成了ATLS课程。其中,72人(41%)资格过期。只有9人(13%)等待重新认证。不同级别外科医生因重大创伤而出现在急诊科的频率存在差异。
所有医院都对重大创伤有应对措施,尽管存在差异。约克郡绝大多数骨科外科医生在ATLS管理方面接受了充分培训(比以往任何研究显示的情况都要好),尤其是中级医生,他们通常是最先到场的。重新认证的水平较低,并对此原因进行了讨论,同时提出了未来重新认证的建议。