From the Department of Pediatrics, Penn State Hershey Children's Hospital, Hershey, PA.
Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA.
Pediatr Emerg Care. 2023 Dec 1;39(12):945-952. doi: 10.1097/PEC.0000000000003073.
This study aimed to determine athletic trainer compliance with emergency medicine and athletic training evidence-based guidelines for the on-the-field management of common pediatric sports-related injury and illness.
A questionnaire was distributed electronically to selected members of the National Athletic Trainer Association. The questionnaire included 10 clinical scenarios describing common sports-related injury/illness (closed head injury, cervical spine injury, blunt chest injury, blunt abdominal injury, ankle injury, knee injury with laceration, heat-related illness). On-the-field management decisions for each scenario were compared with selected emergency medicine and athletic training guidelines.
Analysis was performed on 564 completed questionnaires (9% response rate). Responders were compliant with practice guidelines for both emergency medicine and athletic training except for blunt chest trauma with tachycardia, closed head injury with loss of consciousness, closed head injury with repetitive speech, closed head injury with a fall higher than 5 feet, cervical spine injury with paresthesias, and heat-related illness with persistent symptoms. Discrepancies between emergency medicine and athletic training guidelines included closed head injury with repetitive speech, closed head injury and height of fall, closed head injury and unequal pupils, and cervical spine injury with neck pain and paresthesias.
Based on our sample, athletic trainers were compliant with many guidelines supported by both emergency medicine and athletic training. We identified several deficiencies in the availability of evidence-based guidelines and discrepancies between these guidelines and athletic trainer responses. To provide optimal care to pediatric athletes who sustain injury or illness, emergency medicine and athletic training organizations should collaborate to improve these discrepancies.
本研究旨在确定运动训练员在现场管理常见儿科运动相关损伤和疾病时，对急诊医学和运动训练循证指南的遵守情况。
通过电子邮件向国家运动训练协会的选定成员分发了一份问卷。问卷包括 10 个临床情景，描述了常见的运动相关损伤/疾病（头部闭合伤、颈椎损伤、钝胸部损伤、钝腹部损伤、踝关节损伤、膝关节损伤伴裂伤、与热相关的疾病）。对每个场景的现场管理决策与选定的急诊医学和运动训练指南进行了比较。
对 564 份完成的问卷进行了分析（响应率为 9%）。除了钝性胸部创伤伴心动过速、头部闭合伤伴意识丧失、头部闭合伤伴重复言语、头部闭合伤伴高于 5 英尺的跌倒、颈椎损伤伴感觉异常和与热相关的疾病伴持续症状外，应答者均符合急诊医学和运动训练指南的规定。急诊医学和运动训练指南之间的差异包括重复言语的头部闭合伤、头部闭合伤和跌倒高度、头部闭合伤和瞳孔不等、伴有颈部疼痛和感觉异常的颈椎损伤。
根据我们的样本，运动训练员遵守了许多得到急诊医学和运动训练支持的指南。我们发现一些循证指南的可用性存在不足，并且这些指南与运动训练员的反应之间存在差异。为了为遭受损伤或疾病的儿科运动员提供最佳护理，急诊医学和运动训练组织应合作改善这些差异。
