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奥地利院前医师应急单位用于创伤性出血管理的可用设备:一项全国性调查及对指南依从性的分析

Available equipment for traumatic haemorrhage management in Austrian prehospital physician response units: a nationwide survey and analysis of guideline adherence.

作者信息

Eichinger Michael, Eichlseder Michael, Schützelhofer Gerald, Pichler Alexander, Schreiber Nikolaus, Zoidl Philipp, Honnef Gabriel, Zajic Paul

机构信息

Department of Anaesthesiology and Intensive Care Medicine 1, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.

Medical University of Graz, Graz, Austria.

出版信息

BMC Emerg Med. 2024 Dec 18;24(1):230. doi: 10.1186/s12873-024-01150-3.

Abstract

BACKGROUND

Traumatic injuries, particularly those involving massive bleeding, remain a leading cause of preventable deaths in prehospital settings. The availability of appropriate emergency equipment is crucial for effectively managing these injuries, but the variability in equipment across different response units can impact the quality of trauma care. This prospective survey study evaluated the availability of prehospital equipment for managing bleeding trauma patients in Austria.

METHODS

A nationwide survey was conducted across 139 Austrian Prehospital Physician Response Units (PRUs) to evaluate the presence and adherence to guidelines of bleeding control equipment. The digitally distributed survey included questions on equipment types, such as pelvic binders, tourniquets, haemostatic gauze, and advanced intervention sets. Data were analysed against the most recent recommendations and guidelines to assess conformity and identify gaps.

RESULTS

The survey achieved a 96% response rate, revealing that essential equipment like pelvic binders and tranexamic acid was available in all units, with tourniquets present in 99% of them. However, few services carried advanced equipment for procedures like REBOA or thoracotomy. While satisfaction with the current equipment was high, with 80% of respondents affirming adequacy, the disparities in the availability of specific advanced tools highlight potential areas for improvement, offering a promising opportunity to enhance trauma care capabilities.

CONCLUSIONS

While essential emergency equipment for haemorrhage control is uniformly available across Austrian PRUs, the variation in advanced tools underscores the need for standardised equipment protocols. The urgency for regular kit updates following prehospital guidelines and training is essential to enhance trauma care capabilities and ensure that all emergency response units are equipped to manage severe injuries effectively. This standardisation could lead to improved patient outcomes nationwide.

摘要

背景

创伤性损伤,尤其是那些涉及大量出血的损伤,仍然是院前环境中可预防死亡的主要原因。配备合适的急救设备对于有效处理这些损伤至关重要,但不同急救单位的设备差异会影响创伤护理的质量。这项前瞻性调查研究评估了奥地利用于处理出血性创伤患者的院前设备的可用性。

方法

在奥地利139个院前医师反应单位(PRU)开展了一项全国性调查,以评估出血控制设备的配备情况及对相关指南的遵循情况。通过数字方式分发的调查问卷包含了关于设备类型的问题,如骨盆固定带、止血带、止血纱布和高级干预套件。根据最新的建议和指南对数据进行分析,以评估符合程度并找出差距。

结果

该调查的回复率为96%,结果显示所有单位都配备了骨盆固定带和氨甲环酸等基本设备,99%的单位配备了止血带。然而,很少有服务机构配备用于如主动脉内球囊反搏术(REBOA)或开胸手术等操作的高级设备。虽然对现有设备的满意度较高,80%的受访者确认设备充足,但特定高级工具的配备差异凸显了潜在的改进领域,为提高创伤护理能力提供了一个有前景的机会。

结论

虽然奥地利各PRU均统一配备了用于控制出血的基本急救设备,但高级工具的差异凸显了制定标准化设备方案的必要性。根据院前指南和培训定期更新急救包至关重要,这对于提高创伤护理能力以及确保所有应急反应单位有能力有效处理重伤情况必不可少。这种标准化可能会改善全国范围内患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cec/11658258/4e5e4ed2da8c/12873_2024_1150_Fig1_HTML.jpg

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