标准化创伤课程后的院前分诊表现。
Pre-hospital triage performance after standardized trauma courses.
作者信息
Lampi Maria, Junker Johan, Berggren Peter, Jonson Carl-Oscar, Vikström Tore
机构信息
Centre for Teaching & Research in Disaster Medicine and Traumatology, Department of Clinical and Experimental Medicine, Linköping University, SE-58185, Linköping, Sweden.
出版信息
Scand J Trauma Resusc Emerg Med. 2017 May 19;25(1):53. doi: 10.1186/s13049-017-0395-8.
BACKGROUND
The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass Casualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-Hospital Trauma Life Support courses.
METHODS
A questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident: decision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation. Swedish Advanced Trauma Life Support and Pre-Hospital Trauma Life Support course participants filled in the same triage skills questionnaire just before and after their respective course.
RESULTS
One hundred fifty-three advanced Trauma Life Support course participants were compared to 175 Pre-Hospital Trauma Life Support course participants. The response rates were 90% and 95%, respectively. A significant improvement was found between pre-test and post-test for the Pre-Hospital Trauma Life Support group in regards to decision-making. This difference was only noticeable among the participants who had previously participated in Mass Casualty Incident drills or had experience of a real event (pre-test mean ± standard deviation 2.4 ± 0.68, post-test mean ± standard deviation 2.60 ± 0.59, P = 0.04). No improvement was found between pre-test and post-test for either group regarding prioritization of the bus crash casualties or the correct identification of the most injured patients for immediate evacuation.
CONCLUSIONS
Neither Advanced Trauma Life Support nor Pre-Hospital Trauma Life Support participants showed general improvement in their tested triage skills. However, participation in Mass Casualty Incident drills or experience of real events prior to the test performed here, were shown to be advantageous for Pre-Hospital Trauma Life Support participants. These courses should be modified in order to assure proper training in triage skills.
背景
院前分诊流程旨在识别需要迅速干预和/或疏散的患者并对其进行优先排序。本研究的目的是评估大规模伤亡事件演练中的分诊决策技能。该研究比较了参加高级创伤生命支持课程和院前创伤生命支持课程的两组参与者。
方法
使用一份问卷来处理大规模伤亡事件中受害者分诊的三个组成部分：决策；对一起公交车事故中15名假设伤员的优先排序；以及疏散的优先排序。瑞典高级创伤生命支持课程和院前创伤生命支持课程的参与者在各自课程前后填写相同的分诊技能问卷。
结果
将153名高级创伤生命支持课程参与者与175名院前创伤生命支持课程参与者进行了比较。回复率分别为90%和95%。院前创伤生命支持组在决策方面，测试前和测试后有显著改善。这种差异仅在之前参加过大规模伤亡事件演练或有实际事件经验的参与者中明显（测试前平均值±标准差2.4±0.68，测试后平均值±标准差2.60±0.59，P = 0.04）。在公交车事故伤员的优先排序或正确识别最受伤患者以便立即疏散方面，两组测试前和测试后均未发现改善。
结论
高级创伤生命支持课程参与者和院前创伤生命支持课程参与者在测试的分诊技能方面均未显示出总体改善。然而，对于院前创伤生命支持课程参与者来说，参加大规模伤亡事件演练或在此处测试之前有实际事件经验被证明是有利的。这些课程应进行修改，以确保在分诊技能方面得到适当培训。
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