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印度不同地区创伤的实践模式与管理方案:一项全国性横断面调查。

Practice Patterns and Management Protocols in Trauma across Indian Settings: A Nationwide Cross-sectional Survey.

作者信息

Sodhi Kanwalpreet, Khasne Ruchira Wasudeo, Chanchalani Gunjan, Jagathkar Ganshyam, Kola Venkat Raman, Mishra Mahesh, Sahasrabudhe Shrikant, Mishra Rajesh C, Patel Amrish, Bhavsa Ankur R, Abbas Haider, Routray Pragyan Kumar, Sood Pramod, Rajhans Prasad Anant, Gupta Reshu, Soni Kapil Dev, Kumar Manender

机构信息

Department of Critical Care, Deep Hospital, Ludhiana, Punjab, India.

Department of Critical Care Medicine, SMBT Institute of Medical Sciences and Research Centre, Dhamangaon, Igatpuri, Nashik, Maharashtra, India.

出版信息

Indian J Crit Care Med. 2023 Jan;27(1):38-51. doi: 10.5005/jp-journals-10071-24384.

Abstract

BACKGROUND

Trauma is the leading cause of death in India resulting in a significant public health burden. Indian Society of Critical Care Medicine (ISCCM) has established a trauma network committee to understand current practices and identify the gaps and challenges in trauma management in Indian settings.

MATERIAL AND METHODS

An online survey-based, cross-sectional, descriptive study was conducted with high-priority research questions based on hospital profile, resource availability, and trauma management protocols.

RESULTS

Data from 483 centers were analyzed. A significant difference was observed in infrastructure, resource utilization, and management protocols in different types of hospitals and between small and big size hospitals across different tier cities in India ( < 0.05). The advanced trauma life support (ATLS)-trained emergency room (ER) physician had a significant impact on infrastructure organization and trauma management protocols ( < 0.05). On multivariate analysis, the highest impact of ATLS-trained ER physicians was on the use of extended focused assessment with sonography in trauma (eFAST) (2.909 times), followed by hospital trauma code (2.778 times), dedicated trauma team (1.952 times), and following trauma scores (1.651 times).

CONCLUSION

We found that majority of the centers are well equipped with optimal infrastructure, ATLS-trained physician, and management protocols. Still many aspects of trauma management need to be prioritized. There should be proactive involvement at an organizational level to manage trauma patients with a multidisciplinary approach. This survey gives us a deep insight into the current scenario of trauma care and can guide to strengthen across the country.

HOW TO CITE THIS ARTICLE

Sodhi K, Khasne RW, Chanchalani G, Jagathkar G, Kola VR, Mishra M . Practice Patterns and Management Protocols in Trauma across Indian Settings: A Nationwide Cross-sectional Survey. Indian J Crit Care Med 2023;27(1):38-51.

摘要

背景

创伤是印度主要的死亡原因,造成了巨大的公共卫生负担。印度重症医学学会(ISCCM)成立了一个创伤网络委员会,以了解当前的做法,并找出印度环境下创伤管理中的差距和挑战。

材料与方法

基于医院概况、资源可用性和创伤管理方案,开展了一项基于在线调查的横断面描述性研究,并提出了高优先级的研究问题。

结果

分析了来自483个中心的数据。在印度不同类型的医院以及不同层级城市的大小医院之间,在基础设施、资源利用和管理方案方面观察到显著差异(<0.05)。接受过高级创伤生命支持(ATLS)培训的急诊室(ER)医生对基础设施组织和创伤管理方案有显著影响(<0.05)。多变量分析显示,接受ATLS培训的ER医生影响最大的是在创伤中使用超声扩展聚焦评估(eFAST)(2.909倍),其次是医院创伤代码(2.778倍)、专门的创伤团队(1.952倍)和遵循创伤评分(1.651倍)。

结论

我们发现,大多数中心配备了最佳的基础设施、接受过ATLS培训的医生和管理方案。然而,创伤管理的许多方面仍需优先考虑。应在组织层面积极参与,采用多学科方法管理创伤患者。这项调查让我们深入了解了当前创伤护理的现状,并可为全国范围内的加强工作提供指导。

如何引用本文

Sodhi K, Khasne RW, Chanchalani G, Jagathkar G, Kola VR, Mishra M. 印度环境下创伤的实践模式和管理方案:一项全国性横断面调查。《印度重症医学杂志》2023;27(1):38 - 51。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/201c/9886050/7a5a8451cfef/ijccm-27-38-g001.jpg

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