Mehta Kinneri, Mosha Maua H, Kavanagh Katherine R
Division of Otolaryngology-Head and Neck Surgery, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030, USA.
Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT, 06106, USA.
Int J Pediatr Otorhinolaryngol. 2020 Jun;133:109944. doi: 10.1016/j.ijporl.2020.109944. Epub 2020 Feb 13.
To implement a surgeon led initiative for tracheostomy education for non-surgical pediatric first responders in the hospital setting and to assess its efficacy.
A prospective, observational study conducted from September 2018 to March 2019. All pediatric residents at a tertiary care children's hospital were invited to participate. An objective knowledge test and self-assessment comfort questionnaire was completed before and after the intervention and at 6-month follow up. Educational sessions involved a targeted, interactive program with a didactic presentation and case-based simulation.
Forty-four pediatric residents participated. Residents had limited experience with tracheostomy intervention with only one reporting personally resolving a tracheostomy issue. However, tracheostomy complications were relatively common with 43% reporting having watched another specialty intervene on a tracheostomy issue during an airway related emergency. The objective knowledge test results significantly increased; from pre-knowledge test percent mean of 61.25 (SD = 13.52) to post-knowledge test percent mean of 81.25 (SD = 10.57) [t(39) = -8.144, p < 0.001]. Comfort levels questionnaire median (IQR) results were also significantly higher than pre-intervention [3.70 (3.20-3.88) vs. 2.65 (2.13-3.00), Z = 780, p < .001].
We demonstrated improved knowledge among pediatric residents after a surgeon-led module for tracheostomy care and emergency management. A targeted tracheostomy education program may fill a gap in pediatric resident emergency resuscitation education.
在医院环境中实施一项由外科医生主导的针对非外科儿科急救人员的气管切开术教育计划，并评估其效果。
2018年9月至2019年3月进行了一项前瞻性观察研究。邀请了一家三级护理儿童医院的所有儿科住院医师参与。在干预前后以及6个月随访时完成了客观知识测试和自我评估舒适度问卷。教育课程包括一个有针对性的互动项目，其中有教学演示和基于案例的模拟。
44名儿科住院医师参与。住院医师在气管切开术干预方面经验有限，只有一人报告亲自解决过气管切开术问题。然而，气管切开术并发症相对常见，43%的人报告在气道相关紧急情况期间曾目睹其他专科处理气管切开术问题。客观知识测试结果显著提高；从知识测试前平均百分比61.25（标准差 = 13.52）提高到知识测试后平均百分比81.25（标准差 = 10.57）[t(39) = -8.144，p < 0.001]。舒适度问卷中位数（四分位间距）结果也显著高于干预前[3.70（3.20 - 3.88）对2.65（2.13 - 3.00），Z = 780，p <.001]。
我们证明了在由外科医生主导的气管切开术护理和应急管理模块之后，儿科住院医师的知识有所提高。有针对性的气管切开术教育计划可能填补儿科住院医师紧急复苏教育的空白。
