Batchelder A J, Steel A, Mackenzie R, Hormis A P, Daniels T S, Holding N
University Hospitals of Leicester, Leicester, UK.
Anaesthesia. 2009 Sep;64(9):978-83. doi: 10.1111/j.1365-2044.2009.05990.x.
We conducted a pilot study of the effects of simulation as a tool for teaching doctor-paramedic teams to deliver pre-hospital anaesthesia safely. Participants undertook a course including 43 full immersion, high-fidelity simulations. Twenty videos taken from day 4 and days 9/10 of the course were reviewed by a panel of experienced pre-hospital practitioners. Participants' performance at the beginning and the end of the course was compared. The total time from arrival to inflation of the tracheal tube cuff was longer on days 9/10 than on day 4 (mean (SD) 14 min 52 s (2 min 6 s) vs 11 min 28 s (1 min 54 s), respectively; p = 0.005), while the number of safety critical events per simulation were fewer (median (IQR [range]) 1.0 (0-1.8 [0-2]) vs 3.5 (1.5-4.8 [0-8], respectively; p = 0.011). Crew resource management behaviours also improved in later simulations. On a personal training needs analysis, participants reported increased confidence after the course.
我们进行了一项初步研究，探讨模拟作为一种工具，用于培训医生与护理人员团队安全实施院前麻醉的效果。参与者参加了一个包含43次完全沉浸式、高保真模拟的课程。一组经验丰富的院前从业者对从课程第4天以及第9/10天拍摄的20个视频进行了评估。比较了参与者在课程开始和结束时的表现。从到达现场到气管导管套囊充气的总时间在第9/10天比第4天更长（分别为平均（标准差）14分52秒（2分06秒）和11分28秒（1分54秒）；p = 0.005），而每次模拟中安全关键事件的数量更少（中位数（四分位间距[范围]）分别为1.0（0 - 1.8[0 - 2]）和3.5（1.5 - 4.8[0 - 8]）；p = 0.011）。在后期模拟中，团队资源管理行为也有所改善。根据个人培训需求分析，参与者表示课程结束后信心增强。
