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初级创伤救治课程:发展中国家替代性基本创伤课程。“当下之需”。

Primary trauma care course: Alternative basic trauma course in developing countries. "The Need Of The Hour".

机构信息

Department of Orthopedics, Dr. Ruth K M Pfau Civil Hospital, Karachi, Pakistan.

Department of Orthopedics, United Medical and Dental College, Karachi, Pakistan.

出版信息

Int J Clin Pract. 2021 Aug;75(8):e14327. doi: 10.1111/ijcp.14327. Epub 2021 May 18.

Abstract

OBJECTIVE

Low- and middle-income countries account for over 90% of all road traffic injury deaths. Despite this, formal training in trauma management is not widely adopted in these countries. No specific training was available in prehospital or emergency department for life support before primary trauma care (PTC) course. This study was conducted to assess the effectiveness of the PTC course in the improvement of knowledge and skills of trauma management among participant in Pakistan.

METHOD

Two days of PTC courses were organised and conducted in various regions of Pakistan, participants per course comprising medical students, doctors, house officers, residents, and paramedics. The course comprises lectures of 5 hours and 30 minutes, skills workshops for 3 hours and discussion and multisystem trauma scenarios for 3 hours. Trauma management knowledge and clinical confidence of candidates were assessed using a predetermined multiple-choice questionnaire of 30 MCQs both at pre- and post-course, and using clinical scenarios, confidence matrix was assessed.

RESULTS

A total 7852 of participants were trained, an average of 2 courses per month and 302 total courses. Mean score of pre-course MCQs was 60% and mean score of post-course MCQs was 82%. Among the participant postgraduate trainees, average in trauma knowledge and trauma clinical confidence were significantly higher in both pre- and post-course. The mean score of pre-course confidence matrix was 70% and the mean score of post-course confidence matrix was 93%; at the end of course, all participants showed a high level of confidence in managing trauma mock scenarios. A total of 5889 (75%) participants had a ≥78.5% post-workshop knowledge score. However, only 1963 (25%) participants had a trauma skill score with ≤75 marks.

CONCLUSION

PTC workshop could be an alternative and cost-effective flexible course for gaining knowledge and clinical skills of initial trauma management and strengthening the capacity of trauma management training in developing countries with minimal resources for saving the life of trauma victims.

摘要

目的

中低收入国家占所有道路交通伤害死亡人数的 90%以上。尽管如此,创伤管理方面的正规培训在这些国家并未广泛采用。在初级创伤救治(PTC)课程之前,没有针对院前或急诊科生命支持的特定培训。本研究旨在评估 PTC 课程在提高巴基斯坦参与者创伤管理知识和技能方面的有效性。

方法

在巴基斯坦的不同地区组织并举办了为期两天的 PTC 课程,每期课程的参与者包括医学生、医生、住院医师、住院医师和护理人员。课程包括 5 小时 30 分钟的讲座、3 小时的技能工作坊以及 3 小时的讨论和多系统创伤场景。使用预先确定的 30 个多项选择题问卷评估候选人的创伤管理知识和临床信心,该问卷在课前和课后都进行了评估,并且使用临床场景评估了信心矩阵。

结果

共有 7852 名参与者接受了培训,平均每月 2 门课程,共 302 门课程。课前 MCQ 的平均分数为 60%,课后 MCQ 的平均分数为 82%。在研究生学员中,课前和课后的创伤知识和创伤临床信心的平均分数都显著提高。课前信心矩阵的平均分数为 70%,课后信心矩阵的平均分数为 93%;在课程结束时,所有参与者都对管理创伤模拟场景表现出高度的信心。共有 5889 名(75%)参与者的课后知识得分≥78.5%。然而,只有 1963 名(25%)参与者的创伤技能得分≤75 分。

结论

PTC 讲习班可以作为一种替代方法,以具有成本效益的灵活方式获得初步创伤管理的知识和临床技能,并在资源有限的发展中国家加强创伤管理培训能力,从而挽救创伤受害者的生命。

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