Centre for Prehospital and Emergency Research, Department of Clinical Medicine, Aalborg University Hospital, Aalborg University, Aalborg, Denmark.
Prehospital Emergency Services, Aalborg, North Denmark Region, Denmark.
Scand J Trauma Resusc Emerg Med. 2023 Jan 14;31(1):4. doi: 10.1186/s13049-023-01067-z.
Prehospital vital sign documentation in paediatric patients is incomplete, especially in patients ≤ 2 years. The aim of the study was to increase vital sign registration in paediatric patients through specific educational initiatives.
Prospective quasi-experimental study with interrupted time-series design in the North Denmark and South Denmark regions. The study consecutively included all children aged < 18 years attended by the emergency medical service (EMS) from 1 July 2019 to 31 December 2021. Specific educational initiatives were conducted only in the North Denmark EMS and included video learning and classroom training based on the European Paediatric Advanced Life Support principles. The primary outcome was the proportion of patients who had their respiratory rate, peripheral capillary oxygen saturation, heart rate and level of consciousness recorded at least twice. We used a binomial regression model stratified by age groups to compare proportions of the primary outcome in the pre- and post-intervention periods in each region.
In North Denmark, 7551 patients were included, while 15,585 patients from South Denmark were used as a reference. Virtually all of the North Denmark EMS providers completed the video learning (98.7%). The total study population involved patients aged ≤ 2 months (5.5%), 3-11 months (7.4%), 1-2 years (18.8%), 3-7 years (16.2%) and ≥ 8 years (52.1%). In the intervention region, the primary outcome increased from the pre- to the post-intervention period from 35.3% to 40.5% [95% CI for difference 3.0;7.4]. There were large variations in between age groups with increases from 18.8% to 27.4% [95% CI for difference 5.3;12.0] among patients aged ≤ 2 years, from 33.5% to 43.7% [95% CI for difference 4.9;15.5] among patients aged 3-7 years and an insignificant increase among patients aged ≥ 8 years (from 46.4% to 47.9% [95% CI for difference - 1.7;4.7]). In the region without the specific educational interventions, proportions were steady for all age groups throughout the entire study period.
Mandatory educational initiatives for EMS providers were associated with an increase in the extent of vital sign registration in paediatric patients ≤ 7 years. Incomplete vital registration was associated with, but not limited to non-urgent cases.
在儿科患者中，院前生命体征记录不完整，尤其是在≤2 岁的患者中。本研究的目的是通过特定的教育计划提高儿科患者的生命体征登记率。
在丹麦北部和南部地区进行前瞻性准实验性研究，采用中断时间序列设计。该研究连续纳入了 2019 年 7 月 1 日至 2021 年 12 月 31 日期间由急救医疗服务（EMS）接诊的所有<18 岁的儿童。在丹麦北部 EMS 中进行了特定的教育计划，包括基于欧洲儿科高级生命支持原则的视频学习和课堂培训。主要结局是记录呼吸频率、外周毛细血管血氧饱和度、心率和意识水平至少两次的患者比例。我们使用二项式回归模型，按年龄组分层，比较每个地区干预前和干预后的主要结局比例。
在丹麦北部，纳入了 7551 名患者，而来自南部的 15585 名患者作为参考。几乎所有丹麦北部 EMS 提供者都完成了视频学习（98.7%）。总研究人群包括≤2 个月（5.5%）、3-11 个月（7.4%）、1-2 岁（18.8%）、3-7 岁（16.2%）和≥8 岁（52.1%）的患者。在干预地区，主要结局从干预前的 35.3%增加到干预后的 40.5%[差异的 95%置信区间为 3.0%；7.4%]。各年龄组之间存在较大差异，≤2 岁患者从 18.8%增加到 27.4%[差异的 95%置信区间为 5.3%；12.0%]，3-7 岁患者从 33.5%增加到 43.7%[差异的 95%置信区间为 4.9%；15.5%]，而≥8 岁患者的增长则不显著（从 46.4%增加到 47.9%[差异的 95%置信区间为-1.7%；4.7%]）。在没有特定教育干预的地区，所有年龄组的比例在整个研究期间都保持稳定。
强制性的 EMS 提供者教育计划与儿科患者（≤7 岁）生命体征登记范围的扩大有关。不完整的生命体征记录与非紧急情况有关，但不限于非紧急情况。
