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我们在颈椎固定方面的现状如何?一项针对院前急救人员的问卷调查。

Where Do We Stand on Cervical Spine Immobilisation? A Questionnaire among Prehospital Staff.

作者信息

Gräff Pascal, Bolduan Lisa, Macke Christian, Clausen Jan-Dierk, Sehmisch Stephan, Winkelmann Marcel

机构信息

Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.

出版信息

J Clin Med. 2024 Apr 17;13(8):2325. doi: 10.3390/jcm13082325.

DOI:10.3390/jcm13082325
PMID:38673598
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11050990/
Abstract

: Cervical collars (CC) are routinely used in prehospital trauma treatment. However, over the past years, their application was discussed more critically since they increase intravenous pressure due to reduced venous drainage and the possibility of secondary cervical spine injury. Guidelines have been adjusted accordingly. The question is how efficient has this been put into practice, and how good, as well as up to date, is the knowledge of prehospital emergency medicine personnel about indications on cervical spine immobilisation? : A 15-item questionnaire regarding the self-evaluation and result checking of the right indications for the use of a cervical collar in the prehospital setting was sent to paramedics and emergency doctors in Germany. Two hundred and nineteen completed surveys were statistically analysed. : Mean age of the participants was 30.45 ± 8.8. 72% were male. Regarding subjective safety, the appropriate indication of CC participants reached 79.8 ± 19.5 on a metric scale from 0 (no safety) to 100 (full safety). Mean right answers were as follows: Ambulance man (RS) 0.78 ± 0.84, paramedic (RA) 0.9 ± 0.74, paramedic (NFS) 1.03 ± 0.83 and emergency doctor (ED) 1.75 ± 1.06 ( = 0.013, Kruskal-Wallis Test). Participants who estimated their knowledge < 85% had 0.83 ± 0.8 right answers, and > 85% had 1.14 ± 0.9 right answers. : Rational spine immobilisation is still necessary in severely injured patients. This study highlights the importance of continuing education using ongoing training, lectures or online learning with a questionnaire as a monitor for success to ensure the transfer of evidence-based medicine into daily practice.

摘要

颈椎固定器(CC)在院前创伤治疗中经常使用。然而,在过去几年中,其应用受到了更严格的讨论,因为它们会因静脉引流减少而增加静脉压力,并存在继发颈椎损伤的可能性。相应地,指南也进行了调整。问题是这在实践中实施得有多有效,以及院前急救人员关于颈椎固定指征的知识有多完善和最新?

向德国的护理人员和急诊医生发送了一份关于院前环境中使用颈椎固定器正确指征的自我评估和结果检查的15项问卷。对219份完成的调查问卷进行了统计分析。

参与者的平均年龄为30.45±8.8岁。72%为男性。关于主观安全性,CC参与者的适当指征在从0(无安全性)到100(完全安全性)的量表上达到79.8±19.5。平均正确答案如下:急救员(RS)0.78±0.84,护理人员(RA)0.9±0.74,护理人员(NFS)1.03±0.83,急诊医生(ED)1.75±1.06(=0.013,Kruskal-Wallis检验)。估计自己知识<85%的参与者有0.83±0.8个正确答案,而>85%的参与者有1.14±0.9个正确答案。

对于重伤患者,合理的脊柱固定仍然是必要的。本研究强调了通过持续培训、讲座或在线学习以及使用问卷作为成功监测手段进行继续教育的重要性,以确保循证医学转化为日常实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/90f4e41b1e4e/jcm-13-02325-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/c8befed873cf/jcm-13-02325-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/d3bd6b8575ea/jcm-13-02325-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/f087771f4bd8/jcm-13-02325-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/90f4e41b1e4e/jcm-13-02325-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/c8befed873cf/jcm-13-02325-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/d3bd6b8575ea/jcm-13-02325-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/f087771f4bd8/jcm-13-02325-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1617/11050990/90f4e41b1e4e/jcm-13-02325-g004.jpg

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