Faculty of Medicine, Eberhard Karls University Tübingen, 72076, Tuebingen, Germany.
Department of Anesthesiology, University Hospital RWTH, Aachen, 52074, Aachen, Germany.
Scand J Trauma Resusc Emerg Med. 2017 Aug 14;25(1):79. doi: 10.1186/s13049-017-0426-5.
Prehospital trauma care is stressful and requires multi-professional teamwork. A decrease in the number of accident victims ultimately affects the routine and skills and underlines the importance of effective training. Standardized courses, like PHTLS, are established for health care professionals to improve the prehospital care of trauma patients. The aim of the study was to investigate the subjective safety in prehospital trauma care and learning progress by paramedics in a longitudinal analysis.
This was a prospective intervention trial and part of the mixed-method longitudinal EPPTC-trial, evaluating subjective and objective changes among participants and real patient care as a result of PHTLS courses. Participants were evaluated with pre/post questionnaires as well as one year after the course.
We included 236 datasets. In the pre/post comparison, an increased performance could be observed in nearly all cases. The result shows that the expectations of the participants of the course were fully met even after one year (p = 0.002). The subjective safety in trauma care is significantly better even one year after the course (p < 0.001). Regression analysis showed that (ABCDE)-structure is decisive (p = 0.036) as well as safety in rare and common skills (both p < 0.001). Most skills are also rated better after one year. Knowledge and specific safety are assessed as worse after one year.
The courses meet the expectations of the participants and increase the subjective safety in the prehospital care of trauma patients. ABCDE-structure and safety in skills are crucial. In the short term, both safety in skills and knowledge can be increased, but the courses do not have the power to maintain knowledge and specific subjective safety issues over a year.
German Clinical Trials Register, ID DRKS00004713 , registered 14. February 2014.
院前创伤救护压力大，需要多专业团队协作。事故伤患者数量减少最终会影响常规工作和技能，并强调有效培训的重要性。为提高创伤患者的院前救护水平，为医护人员制定了标准化课程，如 PHTLS。本研究旨在通过纵向分析调查急救员在院前创伤救护中的主观安全性和学习进展。
这是一项前瞻性干预试验，是评估 PHTLS 课程对参与者主观和客观变化以及实际患者护理影响的 EPPTC 混合方法纵向研究的一部分。参与者通过预/后问卷调查，并在课程结束后一年进行评估。
共纳入 236 份数据集。在预/后比较中，几乎所有情况下的表现都有所提高。结果表明，即使在课程结束一年后，参与者对课程的期望也得到了充分满足（p=0.002）。课程结束一年后，创伤救护的主观安全性显著提高（p<0.001）。回归分析表明（ABCDE）结构是决定性的（p=0.036），以及稀有和常见技能的安全性（均 p<0.001）。大多数技能在一年后也得到了更好的评价。知识和特定的安全性在一年后被评估为更差。
这些课程满足了参与者的期望，提高了院前创伤救护中患者的主观安全性。ABCDE 结构和技能安全性至关重要。在短期内，技能和知识的安全性都可以提高，但课程在一年后没有维持知识和特定主观安全问题的能力。
德国临床试验注册处，DRKS00004713，注册日期 2014 年 2 月 14 日。
