Abelsson Anna, Rystedt Ingrid, Suserud Björn-Ove, Lindwall Lillemor
Department of Health Sciences, Karlstad University, Karlstad, Sweden.
Scand J Trauma Resusc Emerg Med. 2014 Mar 28;22:22. doi: 10.1186/1757-7241-22-22.
High energy trauma is rare and, as a result, training of prehospital care providers often takes place during the real situation, with the patient as the object for the learning process. Such training could instead be carried out in the context of simulation, out of danger for both patients and personnel. The aim of this study was to provide an overview of the development and foci of research on simulation in prehospital care practice.
An integrative literature review were used. Articles based on quantitative as well as qualitative research methods were included, resulting in a comprehensive overview of existing published research. For published articles to be included in the review, the focus of the article had to be prehospital care providers, in prehospital settings. Furthermore, included articles must target interventions that were carried out in a simulation context.
The volume of published research is distributed between 1984- 2012 and across the regions North America, Europe, Oceania, Asia and Middle East. The simulation methods used were manikins, films, images or paper, live actors, animals and virtual reality. The staff categories focused upon were paramedics, emergency medical technicians (EMTs), medical doctors (MDs), nurse and fire fighters. The main topics of published research on simulation with prehospital care providers included: Intubation, Trauma care, Cardiac Pulmonary Resuscitation (CPR), Ventilation and Triage.
Simulation were described as a positive training and education method for prehospital medical staff. It provides opportunities to train assessment, treatment and implementation of procedures and devices under realistic conditions. It is crucial that the staff are familiar with and trained on the identified topics, i.e., intubation, trauma care, CPR, ventilation and triage, which all, to a very large degree, constitute prehospital care. Simulation plays an integral role in this. The current state of prehospital care, which this review reveals, includes inadequate skills of prehospital staff regarding ventilation and CPR, on both children and adults, the lack of skills in paediatric resuscitation and the lack of knowledge in assessing and managing burns victims. These circumstances suggest critical areas for further training and research, at both local and global levels.
高能创伤较为罕见，因此，院前急救人员的培训通常在实际情况下进行，以患者作为学习过程的对象。相反，此类培训可以在模拟环境中开展，对患者和人员均无危险。本研究的目的是概述院前急救实践中模拟培训的发展及研究重点。
采用综合文献综述法。纳入基于定量和定性研究方法的文章，从而全面概述已发表的现有研究。要纳入综述的已发表文章，其重点必须是院前环境中的院前急救人员。此外，纳入的文章必须针对在模拟环境中开展的干预措施。
已发表研究的数量分布在1984年至2012年期间，涵盖北美、欧洲、大洋洲、亚洲和中东等地区。所使用的模拟方法包括人体模型、影片、图像或纸质材料、现场演员、动物和虚拟现实。关注的人员类别包括护理人员、急救医疗技术员（EMT）、医生（MD）、护士和消防员。关于院前急救人员模拟培训的已发表研究的主要主题包括：插管、创伤护理、心肺复苏（CPR）、通气和分诊。
模拟培训被描述为院前医务人员积极的培训和教育方法。它提供了在现实条件下培训程序和设备评估、治疗及操作的机会。工作人员熟悉并接受关于已确定主题（即插管、创伤护理、CPR、通气和分诊）的培训至关重要，这些主题在很大程度上构成了院前急救。模拟培训在其中发挥着不可或缺的作用。本综述揭示的院前急救现状包括：院前工作人员在儿童和成人通气及CPR方面技能不足，缺乏儿科复苏技能，以及在评估和管理烧伤患者方面知识欠缺。这些情况表明在地方和全球层面都有进一步培训和研究的关键领域。
