Aekka Apoorva, Abraham Rohit, Hollis Michael, Boudiab Elizabeth, Laput Gieric, Purohit Harshadha, Kumar Richa, Vyas Arpita, Basson Marc, Vyas Dinesh
Department of Surgery, College of Human Medicine, Michigan State University, East Lansing, Michigan.
Jai Narain Vyas University, Jodhpur, Rajasthan, India.
J Surg Res. 2015 Aug;197(2):331-8. doi: 10.1016/j.jss.2015.03.047. Epub 2015 Mar 28.
A major factor contributing to global trauma mortality and morbidity is the lack of effective prehospital trauma services in developing settings. We developed a 2-d training course for nondoctor first responders featuring high-fidelity simulation and video-assisted debriefing, self-directed learning videos, and native language instruction.
A pilot session was conducted in Jodhpur, Rajasthan. Eighteen local instructors were recruited to train 48 layperson first responders in 10 essential subjects. Didactic sessions of 15-20 min consisting of self-directed learning videos were followed by 30-40 min skill sessions featuring high-fidelity simulation, and concluded with 15-20 min video-debriefing periods. Changes in competence were evaluated using pretraining and posttraining surveys.
Results demonstrated that statistically significant competence increases in all areas of trauma management assessed: airway (t[46] = 7.30, P < 0.000), hemorrhage (t[46] = 9.96, P < 0.000), fractures (t[46] = 9.22, P < 0.000), cervical spine injury (t[46] = 12.12, P = 0.000), chest injury (t[46] = 7.84, P < 0.000), IV line placement (t[46] = 4.36, P < 0.000), extrication (t[46] = 2.81, P < 0.005), scene assessment (t[46] = 7.06, P < 0.000), triage (t[46] = 5.92, P < 0.000), and communication (t[46] = 5.56, P < 0.000). Highest increases in competence were observed in cervical spine injury and hemorrhage management, with lowest increases in IV line placement and extrication.
Results suggest this approach may be effective in imparting prehospital trauma management concepts to layperson first responders. This study highlights an innovative educational avenue through which trauma management capacity can be enhanced in developing settings.
在发展中地区，缺乏有效的院前创伤服务是导致全球创伤死亡率和发病率居高不下的一个主要因素。我们为非医生急救人员开发了一个为期两天的培训课程，其特点包括高保真模拟和视频辅助汇报、自主学习视频以及母语教学。
在拉贾斯坦邦焦特布尔市进行了一次试点培训。招募了18名当地教员，对48名非专业急救人员进行10个基本科目的培训。先进行15 - 20分钟由自主学习视频组成的理论课程，接着是30 - 40分钟以高保真模拟为特色的技能课程，最后是15 - 20分钟的视频汇报环节。通过培训前和培训后的调查评估能力变化。
结果表明，在评估的所有创伤管理领域，能力均有统计学意义的提高：气道管理（t[46] = 7.30，P < 0.000）、出血控制（t[46] = 9.96，P < 0.000）、骨折处理（t[46] = 9.22，P < 0.000）、颈椎损伤处理（t[46] = 12.12，P = 0.000）、胸部损伤处理（t[46] = 7.84，P < 0.000）、静脉输液置管（t[46] = 4.36，P < 0.000）、解救（t[46] = 2.81，P < 0.005）、现场评估（t[46] = 7.06，P < 0.000）、分诊（t[46] = 5.92，P < 0.000）以及沟通（t[46] = 5.56，P < 0.000）。能力提高幅度最大的是颈椎损伤处理和出血控制，静脉输液置管和解救的提高幅度最小。
结果表明这种方法可能有效地向非专业急救人员传授院前创伤管理概念。本研究突出了一条创新的教育途径，通过它可以在发展中地区提高创伤管理能力。
