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现场分诊培训对台北市急救医疗技术员的影响。

Effect of Field Triage Training on Emergency Medical Technicians in Taipei City.

作者信息

Chiu Yu-Chen, Wang Liang-Han, Hsieh Ming-Ju, Chien Yu-Chun, Wang Yao-Cheng, Huei-Ming Ma Matthew, Chiang Wen-Chu, Sun Jen-Tang

机构信息

Far Eastern Memorial Hospital Department of Emergency Medicine New Taipei City Taiwan.

National Taiwan University Hospital Department of Emergency Medicine Taipei Taiwan.

出版信息

J Acute Med. 2021 Mar 1;11(1):22-27. doi: 10.6705/j.jacme.202103_11(1).0004.

Abstract

Injury is a leading cause of death among young adults. An accurately implemented fi led triage scheme (FTS) by emergency medical technicians (EMTs) is the first step for delivering right patients to the right hospital. However, the training effect of FTS on EMTs with different levels and backgrounds has scarcely been reported. We evaluated training effects of FTS among EMTs in Taipei. Standard FTS contains physiologic status, anatomical sites of injury, and mechanism of injury criteria. The intervention was a 30-minute lecture and pre-and-post tests, each containing five questions about trauma severity judgment (i.e., mechanism of injury [2 questions], anatomic sites of injury [2 questions], and physiological status [1 question]). The change in EMT accuracy was measured before and after training. Subgroup analyses were performed across EMTs with different levels and seniorities. From September 1, 2015 to March 31, 2016, 821 EMTs were enrolled, including 740 EMT-intermediates and 81 paramedics. Overall, EMT accuracy improved after the intervention in the intermediate (73.2% vs. 85.5%, p < 0.05) and paramedic (76.0% vs. 85.7%, p <0.01) groups. All trainees showed improvements in physiology and mechanism criteria, but paramedics showed decreased accuracy in anatomic criteria. The subgroup analysis showed that accuracy positively associated with prehospital care experience for major trauma cases 1 year before the training course, and the anatomical criterion accuracy was adversely associated with paramedic seniority. Field triage training can improve EMT accuracy for FTS. The anatomical aspect is more diffi cult to improve and should be emphasized in FTS training courses.

摘要

损伤是年轻成年人死亡的主要原因。急诊医疗技术人员(EMT)准确实施的现场分诊方案(FTS)是将合适的患者送到合适医院的第一步。然而,FTS对不同水平和背景的EMT的培训效果鲜有报道。我们评估了台北市EMT中FTS的培训效果。标准FTS包含生理状态、损伤的解剖部位和损伤机制标准。干预措施为30分钟的讲座及前后测试,每次测试包含五个关于创伤严重程度判断的问题(即损伤机制[2个问题]、损伤的解剖部位[2个问题]和生理状态[1个问题])。在培训前后测量EMT准确性的变化。对不同水平和资历的EMT进行亚组分析。2015年9月1日至2016年3月31日,共纳入821名EMT,包括740名中级EMT和81名护理人员。总体而言,干预后中级EMT组(73.2%对85.5%,p<0.05)和护理人员组(76.0%对85.7%,p<0.01)的EMT准确性有所提高。所有学员在生理和机制标准方面均有提高,但护理人员在解剖标准方面的准确性下降。亚组分析表明,准确性与培训课程前1年重大创伤病例的院前护理经验呈正相关,解剖标准准确性与护理人员资历呈负相关。现场分诊培训可提高EMT对FTS的准确性。解剖方面更难提高,应在FTS培训课程中予以强调。

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