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[对受伤儿童院前护理的不同期望?:儿科外科医生与创伤外科医生的比较]

[Different expectations regarding the prehospital care of injured children? : A comparison between pediatric surgeons and trauma surgeons].

作者信息

Kraus Ralf, Markmann Melanie, Riedel Jens Günter, Schneck Emmanuel

机构信息

Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Rudolf Buchheim Str. 7, 35385, Gießen, Deutschland.

Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Gießen, Deutschland.

出版信息

Chirurgie (Heidelb). 2025 Jul 11. doi: 10.1007/s00104-025-02352-6.

Abstract

INTRODUCTION

The prehospital care of injured children is challenging. Immobilization and pharmacological pain management are in the foreground; however, the expectations of pediatric surgeons and trauma surgeons regarding emergency medical services and emergency physicians can vary. This study aims to identify similarities and differences.

METHODS

In this study 186 members of the Pediatric Traumatology Section of the German Society for Trauma Surgery were surveyed on the necessity of 9 emergency medical interventions using 10 routine case studies.

RESULTS

A total of 26 pediatric surgeons and 31 trauma surgeons provided their assessments. There were significant differences in assessment regarding the use of pharmacological pain management, the need for neurological assessment and reduction maneuvers with analgesia. There was high agreement regarding immobilization of the injured body region, the establishment of an intravenous approach and sterile closure of open fractures.

DISCUSSION

Pediatric traumatologists with trauma surgery and pediatric surgery training have different priorities in their requirements for the prehospital care of injured children. Joint interdisciplinary recommendations for action should be formulated to provide widely accepted guidelines for emergency medical personnel, who often do not specialize in pediatric traumatology.

摘要

引言

受伤儿童的院前护理具有挑战性。固定和药物性疼痛管理是重点;然而,小儿外科医生和创伤外科医生对紧急医疗服务和急诊医生的期望可能有所不同。本研究旨在找出异同点。

方法

在本研究中,使用10个常规病例研究,对德国创伤外科学会小儿创伤科的186名成员进行了9种紧急医疗干预必要性的调查。

结果

共有26名小儿外科医生和31名创伤外科医生提供了评估。在药物性疼痛管理的使用、神经学评估的必要性以及镇痛下的复位操作方面,评估存在显著差异。在受伤身体部位的固定、建立静脉通路以及开放性骨折的无菌闭合方面,意见高度一致。

讨论

接受过创伤外科和小儿外科培训的小儿创伤学家在受伤儿童院前护理的要求上有不同的侧重点。应制定联合跨学科行动建议,为通常并非小儿创伤学专科的紧急医疗人员提供广泛接受的指导方针。

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