Kong Victor Y, Oosthuizen George V, Sartorius Benn, Keene Claire M, Clarke Damian L
Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
J Surg Educ. 2015 Jul-Aug;72(4):600-5. doi: 10.1016/j.jsurg.2015.01.022. Epub 2015 Mar 23.
To review the ability of junior doctors (JDs) in identifying the correct anatomical site for intercostal chest drain insertion and whether prior Advanced Trauma Life Support (ATLS) training influences this.
We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact preferred site for intercostal chest drain insertion.
This study was conducted in a large metropolitan university hospital in South Africa.
A total of 152 JDs participated in the study. Among them, 63 (41%) were men, and the mean age was 24 years. There were 90 (59%) PGY1 doctors and 62 (41%) PGY2 doctors. Overall, 28% (42/152) of all JDs correctly identified the site that was located within the accepted safe triangle. A significantly higher proportion of PGY2 doctors selected the correct site when compared with PGY1 doctors (39% vs 20%, p = 0.026). Those who had prior ATLS provider training were 6.8 times more likely to be able to identify the correct site (RR = 6.8, 95% CI: 3.7-12.5).
Most of the JDs do not have sufficient anatomical knowledge to identify the safe insertion site for intercostal chest drain. Those who had undergone ATLS training were more likely to be able to identify the safe insertion site.
评估初级医生（JDs）确定肋间胸腔引流管插入正确解剖部位的能力，以及先前的高级创伤生命支持（ATLS）培训是否对此有影响。
我们采用结构化调查进行了一项前瞻性观察研究，要求一组初级医生（研究生一年级[PGY1]或二年级[PGY2]）在一张照片上指出肋间胸腔引流管插入的确切首选部位。
本研究在南非一家大型都市大学医院进行。
共有152名初级医生参与了研究。其中，63名（41%）为男性，平均年龄为24岁。有90名（59%）PGY1医生和62名（41%）PGY2医生。总体而言，所有初级医生中有28%（42/152）正确识别出位于公认安全三角区内的部位。与PGY1医生相比，PGY2医生中选择正确部位的比例显著更高（39%对20%，p = 0.026）。那些先前接受过ATLS提供者培训的人识别正确部位的可能性高6.8倍（相对危险度 = 6.8，95%可信区间：3.7 - 12.5）。
大多数初级医生没有足够的解剖学知识来识别肋间胸腔引流管的安全插入部位。那些接受过ATLS培训的人更有可能识别出安全插入部位。
