针对战场上无系统医学教育经验战斗人员的急救培训：中国课程体系的建立与评估

First-aid Training for Combatants Without Systematic Medical Education Experience on the Battlefield: Establishment and Evaluation of the Curriculum in China.

作者信息

Qin Hao, Liu Daocheng, Chen Sixu, Lyv Mingrui, Yang Lei, Bao Quanwei, Zong Zhaowen

机构信息

Department of War Wound Rescue Skills Training, Base of Army Health Service Training, Army Medical University, Chongqing 400038, China.

Unit 77115 of the Chinese People's Liberation Army, Chengdu, Sichuan 611235, China.

出版信息

Mil Med. 2020 Sep 18;185(9-10):e1822-e1828. doi: 10.1093/milmed/usaa152.

DOI:10.1093/milmed/usaa152

PMID:32601667

Abstract

INTRODUCTION

For combatants without systematic medical education experience (CSMEE), it is necessary to participate in first-aid on the battlefield, but currently there is no effective training curriculum for CSMEE in Chinese military.

MATERIALS AND METHODS

A list of first-aid techniques based on expert consensus was formed, and then a curriculum was established according to the list. The effectiveness of the curriculum was further evaluated by comparing the scores among group A (the reserve officers trained by this curriculum), group B (the reserve officers in the military medical college trained by professional medic training system), and group C (the fresh officers trained by the Outline of Military Training and Assessment of Chinese military), through a 5-station assessment in a simulated battlefield environment, which included the following 5 techniques: tourniquet for massive extremities hemorrhage, thyrocricocentesis, thoracentesis, fixation of long bone fractures, and wound dressing with hemostatic bandage.

RESULTS

The training curriculum entitled "Implementation and Assessment Standards of First-aid Training for Combatants on the Battlefield" was established. The comparison of average scores in the 5-station assessment showed that group A had better scores than group C in tourniquet for massive extremity hemorrhage, thyrocricocentesis, and thoracentesis, with no significant differences compared with group B. Also, no significant difference between groups A and B in overall completion time and overall scores was observed, whereas an excellent candidate rate in overall score of group B was better than that of group A (87.4% vs. 80.9%, χ2 = 4.40, p = 0.036), and group A was better than group C (80.9% vs. 37.5%, χ2 = 62.01, p < 0.001).

CONCLUSION

The established training curriculum is indeed effective, which improved the CSMEE's first-aid capacity on the battlefield, and is equivalent to the level of medics.

摘要

引言

对于没有系统医学教育经历的战斗人员（CSMEE）而言，参与战场急救很有必要，但目前中国军队中尚无针对CSMEE的有效培训课程。

材料与方法

形成一份基于专家共识的急救技术清单，然后根据该清单制定课程。通过在模拟战场环境下进行五站式评估，比较A组（接受本课程培训的预备役军官）、B组（在军医大学接受专业医疗培训系统培训的预备役军官）和C组（按照中国军队军事训练与考核大纲培训的新军官）的得分，进一步评估课程的有效性，该评估包括以下五项技术：四肢大出血止血带应用、环甲膜穿刺术、胸腔穿刺术、长骨骨折固定以及用止血绷带包扎伤口。

结果

制定了名为“战场战斗人员急救培训实施与评估标准”的培训课程。五站式评估中的平均得分比较显示，A组在四肢大出血止血带应用、环甲膜穿刺术和胸腔穿刺术方面的得分高于C组，与B组相比无显著差异。此外，A组和B组在总完成时间和总分方面未观察到显著差异，而B组的总分优秀候选率优于A组（87.4%对80.9%，χ2 = 4.40，p = 0.036），A组优于C组（80.9%对37.5%，χ2 = 62.01，p < 0.001）。