Fisher Andrew D, Naylor Jason F, April Michael D, Thompson Dominic, Kotwal Russ S, Schauer Steven G
J Spec Oper Med. 2020 Winter;20(4):53-59. doi: 10.55460/L8S6-CU4F.
Role 1 care represents all aspects of prehospital care on the battlefield. Recent conflicts and military operations conducted on behalf of the Global War on Terrorism have resulted in medical officers (MOs) being used nondoctrinally on combat missions. We are seeking to describe Role 1 trauma care provided by MOs and compare this care to that provided by medics.
This is a secondary analysis of previously described data from the Prehospital Trauma Registry and the Department of Defense Trauma Registry from April 2003 through May 2019. Encounters were categorized by type of care provider (MO or medic). If both were documented, they were categorized as MO; those without either were excluded. Descriptive statistics were used.
A total of 826 casualty encounters met inclusion criteria. There were 418 encounters categorized as MO (57 with MO, 361 with MO and medic), and 408 encounters categorized as medic only. The composite injury severity score (median, interquartile range) was higher for casualties treated by the medic cohort (9, 3.5-17) than for the MO cohort (5, 2-9.5; P = .006). There was no difference in survival to discharge between the MO and medic groups (98.6% vs. 95.6%; P = .226). More life-saving interventions were performed by MOs compared to medics. MOs demonstrated a higher rate of vital sign documentation than medics.
More than half of casualty encounters in this study listed an MO in the chain of care. The difference in proportion of interventions highlights differences in provider skills, training and equipment, or that interventions were dictated by differences in mechanisms of injury.
1 级护理涵盖战场上院前护理的各个方面。近期代表全球反恐战争开展的冲突和军事行动导致医务人员在战斗任务中未按常规使用。我们试图描述医务人员提供的 1 级创伤护理，并将其与医护兵提供的护理进行比较。
这是对 2003 年 4 月至 2019 年 5 月期间院前创伤登记处和国防部创伤登记处先前描述的数据进行的二次分析。根据护理提供者类型（医务人员或医护兵）对接触情况进行分类。如果两者都有记录，则分类为医务人员；两者都没有记录的则排除。使用描述性统计方法。
共有 826 次伤亡接触符合纳入标准。其中 418 次接触分类为医务人员（57 次仅有医务人员，361 次有医务人员和医护兵），408 次接触仅分类为医护兵。医护兵组治疗的伤亡者的综合损伤严重程度评分（中位数，四分位间距）高于医务人员组（9，3.5 - 17 对比 5，2 - 9.5；P = 0.006）。医务人员组和医护兵组出院生存率无差异（98.6% 对比 95.6%；P = 0.226）。与医护兵相比，医务人员进行的挽救生命的干预更多。医务人员记录生命体征的比例高于医护兵。
本研究中超过一半的伤亡接触在护理链中列出了医务人员。干预比例的差异突出了提供者技能、培训和设备的差异，或者干预是由损伤机制的差异所决定的。
