Ray Adam M, Sole David P
Department of Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA.
J Emerg Med. 2007 Nov;33(4):385-94. doi: 10.1016/j.jemermed.2007.02.051. Epub 2007 Jul 5.
Emergency Medical Services (EMS) activities are a required component of Emergency Medicine (EM) residency training. To determine resident involvement with EMS, all 135 Accreditation Council for Graduate Medical Education-accredited and 34 American Osteopathic Association-accredited EM residencies were surveyed in June 2005 regarding the EMS activities required of their residents. One hundred twelve surveys were completed (66% response rate). Observing with ground EMS is required in 88% (n = 98) of residencies; working as an EMS provider is required in 28% (n = 31). Helicopter-based EMS involvement is uncommon, only 16% (n = 18) require observing and 21% (n = 23) require working as a provider. Most residencies (60%, n = 67) allow optional helicopter observation. Insufficient time is the most common reason for limiting EMS activities. Residents routinely provide on-line medical command (79%, n = 88). Most residencies (72%, n = 81) require lecturing to prehospital personnel; a minority require serving as Advanced Cardiac Life Support (38%, n = 42) or Advanced Trauma Life Support (13%, n = 14) instructors. Disaster training is required of most residents (73%, n = 82), whereas providing medical care at a mass gathering is not frequently required (28%, n = 31). Except for reviewing EMS patient care reports (54%, n = 60), quality improvement activities are rarely required. Serving as a medical director or assistant medical director for an EMS service is seldom required (6%, n = 7), and most residencies (63%, n = 70) do not specifically provide financial support for EMS physician-related training.
紧急医疗服务（EMS）活动是急诊医学（EM）住院医师培训的必要组成部分。为了确定住院医师参与EMS的情况，2005年6月对所有135个经研究生医学教育认证委员会认证以及34个经美国骨病协会认证的EM住院医师培训项目进行了调查，了解其对住院医师所需的EMS活动要求。共完成了112份调查问卷（回复率为66%）。88%（n = 98）的住院医师培训项目要求参与地面EMS观察；28%（n = 31）要求担任EMS提供者。参与直升机EMS的情况并不常见，只有16%（n = 18）要求观察，21%（n = 23）要求担任提供者。大多数住院医师培训项目（60%，n = 67）允许选择性参与直升机观察。时间不足是限制EMS活动的最常见原因。住院医师常规提供在线医疗指挥（79%，n = 88）。大多数住院医师培训项目（72%，n = 81）要求为院前人员授课；少数要求担任高级心脏生命支持（38%，n = 42）或高级创伤生命支持（13%，n = 14）教员。大多数住院医师（73%，n = 82）需要接受灾难培训，而在大型集会中提供医疗服务的要求并不常见（28%，n = 31）。除了审查EMS患者护理报告（54%，n = 60）外，很少要求开展质量改进活动。很少要求担任EMS服务的医疗主任或助理医疗主任（6%，n = 7），大多数住院医师培训项目（63%，n = 70）没有专门为与EMS医师相关的培训提供资金支持。
