Department of Dentistry, Children's Hospital, Boston, MA 02492, USA.
Dent Traumatol. 2013 Aug;29(4):272-9. doi: 10.1111/j.1600-9657.2012.01170.x. Epub 2012 Jul 16.
Hospital emergency departments (ED) are confronted with triaging and managing dental emergencies of both traumatic and non-traumatic origin. However, the literature suggests that there exists inadequate knowledge of the management of traumatic dental injuries (TDI) among medical professionals who must be knowledgeable and have the appropriate resources needed to triage or treat patients presenting with TDI.
The aims of this study were to (i) evaluate the resources of Massachusetts emergency departments (MEDs) for TDI, (ii) determine the knowledge of management of TDI among MED physicians, and (iii) investigate potential factors that affect their knowledge.
Surveys were mailed to MED directors and their physicians. The director survey contained questions regarding institutional information for each emergency department (ED). The physician survey contained questions about physician characteristics and tested their knowledge of managing dental trauma.
A total of 72 surveys (16 MED directors and 56 physicians) were returned and included in the analysis. Only 50% of the MEDs had on-site dental coverage, 43.8% had 24-h off-site dental coverage, and none had a formal written dental trauma protocol. MED physician's knowledge of the appropriate management of luxations and avulsions was generally good, but poor for dental fractures. The MED physician's knowledge for the emergent nature of the various injuries was generally good with that of avulsions being the best. Physicians were more likely to have a better knowledge of managing dental trauma if they were specialists in pediatric emergency medicine (P = 0.001) or their hospitals had an academic affiliation (P = 0.05).
Based on the findings from this study, educational campaigns must be undertaken to improve both the resources available to the ED, and the knowledge of physicians regarding emergency management of TDI. In addition, efforts should be made by local dental organizations to provide ED with lists of dentists who are knowledgeable and willing to be available 24 h day⁻¹ to consult with and, if necessary, treat TDI. These efforts would enhance the long-term outcomes for patients sustaining dental trauma who present to hospital ED.
医院急诊部门（ED）面临着创伤性和非创伤性来源的牙科急症的分诊和管理。然而，文献表明，必须了解分诊或治疗创伤性牙外伤（TDI）患者的医学专业人员对 TDI 的管理知识不足，并且需要有适当的资源。
本研究旨在：（i）评估马萨诸塞州急诊部（ED）的 TDI 资源，（ii）确定 ED 医师对 TDI 管理的知识，以及（iii）调查影响其知识的潜在因素。
向 ED 主任及其医师邮寄了调查。主任调查包含有关每个急诊部（ED）机构信息的问题。医师调查包含有关医师特征的问题，并测试了他们对牙科创伤管理的知识。
共返回并分析了 72 份调查（16 名 ED 主任和 56 名医师）。只有 50％的 ED 有现场牙科覆盖，43.8％有 24 小时场外牙科覆盖，并且没有正式的书面牙科创伤协议。ED 医师对脱位和脱落的适当处理的知识通常很好，但对牙折的知识却很差。ED 医师对各种损伤的紧急性质的认识通常很好，其中以脱落为最佳。如果医师是儿科急诊医学专家（P = 0.001）或其医院有学术附属关系（P = 0.05），则他们更有可能具有更好的牙科创伤管理知识。
根据本研究的结果，必须开展教育活动，以改善 ED 可用的资源，并提高医师对 TDI 紧急管理的知识。此外，应通过当地牙科组织努力为 ED 提供知识渊博且愿意 24 小时提供咨询服务并在必要时治疗 TDI 的牙医名单。这些努力将增强因牙科外伤而就诊于医院 ED 的患者的长期预后。
