Emergency Medical Services of the Karlovy Vary Region, Karlovy Vary, Czech Republic.
Prague Emergency Medical Services, Prague, Czech Republic.
BMC Emerg Med. 2022 May 13;22(1):83. doi: 10.1186/s12873-022-00642-4.
Non-technical skills (NTS) are important for the proper functioning of emergency medical ambulance crews but have hardly been researched in the conditions of clinical pre-hospital care. The primary objective of this study, therefore, is to describe the use of NTS in practice. The secondary objective is to compare if the performance of NTS varies according to the type of case.
In this multicentric observational study the modified Team Emergency Assessment Measure (TEAM) score was used to assess the performed NTS of two or more crews on site. The evaluation consisted of leadership, teamwork and task management, rated by a field supervisor. The study observations took place in real clinical pre-hospital emergency medical cases when two or more crews were dispatched between October 2019 and August 2020. The sample size was determined by researchers prior to the study to at least 100 evaluated events per each of the three participating emergency medical services. The results are presented as median and interquartile range. The internal reliability, consistency and validity of test items and results were evaluated. The Kruskal-Wallis test and the post hoc Mann-Whitney U test with Bonferroni correction were used for multiple comparisons of three groups.
A total of 359 events were evaluated. Surprisingly, the median value for all eight items was as high as 3.0 with a similar interquartile range of 1.0. There were no differences observed by case type (CPR vs. TRAUMA vs. MEDICAL) except from item 1. A post hoc analysis revealed that this difference is in favour of a higher rated performance of non-technical skills in CPR.
The overall result of the performance of non-technical skills can be regarded as very good and can serve for further evaluations. The crews achieved better parameters of NTS in leadership in resuscitation situations in comparison with general medical events.
The study is registered at Clinical Trials under the ID: NCT04503369 .
非技术技能（NTS）对于紧急医疗救护车人员的正常运作至关重要，但在临床院前护理条件下几乎没有得到研究。因此，本研究的主要目的是描述 NTS 在实践中的使用情况。次要目的是比较 NTS 的表现是否因病例类型而异。
在这项多中心观察性研究中，使用改良的团队紧急评估量表（TEAM）评分来评估现场两名或多名人员执行的 NTS。评估由现场主管进行，包括领导力、团队合作和任务管理。研究观察发生在 2019 年 10 月至 2020 年 8 月期间，当两个或更多的急救人员被派遣到两个或更多的急救人员时。样本量由研究人员在研究前确定，每个参与的紧急医疗服务至少评估 100 个事件。结果以中位数和四分位距表示。评估了测试项目和结果的内部可靠性、一致性和有效性。使用 Kruskal-Wallis 检验和事后 Mann-Whitney U 检验（Bonferroni 校正）对三组进行多重比较。
共评估了 359 个事件。令人惊讶的是，所有八项指标的中位数均高达 3.0，四分位距相似，为 1.0。除了项目 1 外，病例类型（CPR 与 TRAUMA 与 MEDICAL）之间没有观察到差异。事后分析显示，这一差异有利于在 CPR 中更高的非技术技能表现评分。
非技术技能表现的总体结果可以被认为是非常好的，并可以进一步评估。与一般医疗事件相比，在复苏情况下，急救人员在领导能力方面的非技术技能参数表现更好。
该研究在临床试验中注册，ID 为 NCT04503369。
