Hafis Mohd S, Johar Mohd J, Mahathar Abdul-Wahab, Saiboon Ismail M
Department of Emergency Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia. E-mail.
Saudi Med J. 2014 Aug;35(8):855-60.
To assess the acceptance among the developing country urban paramedics towards pre-hospital continuous positive airway pressure (CPAP) ventilation.
A cross-sectional prospective study was conducted among the ambulance paramedics working at the pre-hospital care unit of the Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia from March 2012 to August 2012 on ambulance paramedics. Questionnaires were used to assess their experience, knowledge, and perception, while their competencies were assessed using an Objective Structured Clinical Examination by 2 independent-calibrated raters on the use of the Boussignac CPAP system.
Twenty-six ambulance paramedics qualified for this study with an average work experience of 5.59+/-3.53 years. A total of 76.9% had no formal training for CPAP during their study years. Knowledge of CPAP apparatus-arrangement sequence scored as 88.5% correct, while 96.2% scored Good to Very-good in the ability to diagnose conditions that warrant its use. A total of 76.9% were confident to monitor patients on CPAP, and 61.5% in applying the device. However, only 53.8% were confident to start the CPAP, and 38.5% to troubleshoot if any problem arose. For perceptions, 96.2% felt it was easy to learn CPAP, while 88.5% felt that paramedics could use it without supervision, and 80.8% felt that it should not be confined to the Emergency Department setting. A total of 96.1% were competent in CPAP application.
Developing country urban ambulance paramedics possessed adequate knowledge, positive attitudes, and demonstrated good CPAP application skills. However, lack of confidence towards decision to initiate and troubleshoot of potential complications were the main obstacles hindering its use.
评估发展中国家城市急救医护人员对院前持续气道正压通气（CPAP）的接受程度。
2012年3月至2012年8月，在马来西亚吉隆坡马来西亚国民大学医学中心院前护理单元工作的救护车医护人员中开展了一项横断面前瞻性研究。采用问卷调查评估他们的经验、知识和认知，同时由2名独立校准的评估者通过客观结构化临床考试评估他们使用布西尼亚克CPAP系统的能力。
26名救护车医护人员符合本研究条件，平均工作经验为5.59±3.53年。在学习期间，共有76.9%的人没有接受过CPAP的正规培训。CPAP设备布置顺序的知识正确率为88.5%，而在诊断需要使用CPAP的病情的能力方面，96.2%的人得分“良好”至“非常好”。共有76.9%的人有信心对接受CPAP治疗的患者进行监测，61.5%的人有信心应用该设备。然而，只有53.8%的人有信心启动CPAP，38.5%的人有信心在出现任何问题时进行故障排除。在认知方面，96.2%的人认为学习CPAP很容易，88.5%的人认为急救医护人员可以在无监督的情况下使用它，80.8%的人认为它不应局限于急诊科环境。共有96.1%的人能够胜任CPAP的应用。
发展中国家城市救护车医护人员具备足够的知识、积极的态度，并展示出良好的CPAP应用技能。然而，对启动CPAP的决策缺乏信心以及对潜在并发症进行故障排除是阻碍其使用的主要障碍。
