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高风险、低容量:在急救员困难气道培训课程中评估可重复使用的环甲膜切开模型。

High Risk, Low Volume: Evaluation of a Reusable Cricothyrotomy Model in a Paramedic Difficult Airway Training Course.

机构信息

Northern Arizona Healthcare, Flagstaff, AZ.

Department of Emergency Medicine, University of Arizona, Tucson, AZ.

出版信息

Air Med J. 2020 Sep-Oct;39(5):380-382. doi: 10.1016/j.amj.2020.05.017. Epub 2020 Jun 19.

Abstract

OBJECTIVE

Cricothyrotomy is rarely performed by prehospital providers. Developing this low-frequency, high-acuity skill and maintaining competence is difficult; thus, using a realistic training model is paramount to successful training. The aim of this study was to evaluate a 3-dimensional-printed bleeding cricothyrotomy trainer in increasing paramedic comfort level and procedural competence as defined by completing the procedure unassisted without error.

METHODS

Model implementation took place during mandatory biannual difficult airway training courses for all paramedics employed by a hospital-based ambulance agency. Participating paramedics performed 3 surgical cricothyrotomies using the bleeding trainer and subsequently completed an anonymous written survey that evaluated the comfort level of providers in performing a surgical cricothyrotomy both before and after training using a 10-point visual analog scale.

RESULTS

Forty-four paramedics participated in the difficult airway training course. All (44/44) completed the postsurvey. Participants noted that their procedural skill comfort level improved after the training took place (average improvement of 3 ± 1.93). Participants also indicated that the high-fidelity trainer played a significant role in their increased comfort after skills training.

CONCLUSION

The bleeding cricothyrotomy model evaluated provides a high-fidelity, cost-effective means of teaching and maintaining a rare, lifesaving skill that is rarely performed in the field.

摘要

目的

环甲切开术很少由院前急救人员执行。开发这种低频、高难度技能并保持熟练程度是很困难的;因此,使用现实的训练模型对于成功的训练至关重要。本研究的目的是评估一种 3D 打印的出血性环甲切开术训练器,以提高护理人员的舒适度和程序能力,具体定义为在没有错误的情况下独立完成手术。

方法

模型的实施是在一家医院救护车机构的所有护理人员强制性的双年度困难气道培训课程中进行的。参与的护理人员使用出血训练器进行了 3 次外科环甲切开术,随后完成了一项匿名书面调查,该调查使用 10 分制视觉模拟量表评估了提供者在培训前后进行外科环甲切开术的舒适度。

结果

44 名护理人员参加了困难气道培训课程。所有人(44/44)都完成了调查。参与者指出,培训后他们的手术技能舒适度有所提高(平均提高 3 ± 1.93)。参与者还表示,高保真训练器在他们的技能培训后增加舒适度方面发挥了重要作用。

结论

评估的出血性环甲切开术模型提供了一种高保真、具有成本效益的教学和维持很少在现场进行的罕见救生技能的方法。

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