Department of Surgical Sciences, Department Anaesthesiology and Critical Care, Tygerberg Hospital, Stellenbosch University, Western Cape, South Africa.
Pan Afr Med J. 2021 Sep 16;40:41. doi: 10.11604/pamj.2021.40.41.30134. eCollection 2021.
the coronavirus disease 2019 (COVID-19) pandemic has negatively impacted countries across the globe. Infected individuals will seek aid at various health care facilities. Many patients will recover without requiring specialised treatment. A significant percentage of infected individuals will need critical care management, which will begin in the emergency department, generally staffed by junior doctors. Junior doctors will need to stabilize, triage and manage these patients prior to referral to specialized units. Above and beyond the usual occupational demands that accompany junior doctors in state facilities, this pandemic will thrust further responsibility on them. The objectives were to describe crisis preparedness of junior doctors in the areas of triage decision-making and critical care management, outside the intensive care unit.
this is a descriptive, cross-sectional study, utilizing a web-based survey. Junior doctors in South Africa, being doctors in year one or year two of internship and community service, were invited to participate anonymously via various social media platforms. a total of 210 junior doctors across South Africa answered the survey. Junior doctors expressed confidence with knowledge of intubation drugs, to perform intubation and cardiopulmonary arrest resuscitation without supervision. Only 13.3% of respondents expressed comfort with setting and adjusting ventilator settings independently. 57% of participants expressed discomfort with making critical care triage decisions. Ninety-three percent (93%) of participants expressed benefit from a telemedicine intervention.
junior doctors in South Africa indicate that they are prepared to initiate management of the critically ill patient outside the intensive care unit but remain uncertain in their ability to provide ongoing critical care management. The COVID-19 pandemic has highlighted the need to prepare junior doctors with the ability to manage critical care triage and management in emergency rooms. Leveraging of the workforce in South Africa may be potentiated by telemedicine interventions.
2019 年冠状病毒病（COVID-19）大流行对全球各国产生了负面影响。受感染的个人将在各种医疗保健设施寻求帮助。许多患者无需特殊治疗即可康复。有相当一部分受感染的人需要重症监护管理，这将从急诊科开始，通常由初级医生负责。初级医生需要在将患者转介至专科病房之前稳定、分诊和管理这些患者。除了在国有设施中伴随初级医生的常规职业要求之外，这场大流行将使他们承担更多的责任。目的是描述初级医生在分诊决策和重症监护管理方面的危机准备情况，而不在重症监护病房内。
这是一项描述性的横断面研究，利用网络调查。邀请南非的初级医生（实习和社区服务的第一年或第二年）匿名参与，通过各种社交媒体平台进行。共有 210 名南非初级医生回答了调查。初级医生对插管药物、在没有监督的情况下进行插管和心肺复苏的知识表示有信心。只有 13.3%的受访者表示在独立设置和调整呼吸机参数方面感到舒适。57%的参与者表示在做出重症监护分诊决策时感到不舒服。93%的参与者（93%）表示受益于远程医疗干预。
南非的初级医生表示，他们准备在重症监护病房外开始对重症患者进行管理，但对自己提供持续重症监护管理的能力仍不确定。COVID-19 大流行凸显了需要培养初级医生的能力，使其能够在急诊室进行重症监护分诊和管理。通过远程医疗干预，可以增强南非劳动力的潜力。
