Cone D C, McNamara R M
Department of Emergency Medicine, MCP-Hahnemann School of Medicine, Allegheny University of the Health Sciences, Philadelphia, PA 19129-1121, USA.
Prehosp Emerg Care. 1998 Apr-Jun;2(2):123-6. doi: 10.1080/10903129808958855.
To study the incidence and nature of injuries sustained by emergency medicine (EM) residents during EMS rotations, and steps taken at EM residency programs to increase resident safety during field activities.
An eight-question survey form was mailed to all 114 U.S. EM residency directors, with a second mailing to nonresponders eight weeks after the initial mailing.
A total of 105 surveys were returned (92%). Six surveys were from new programs whose residents have not yet rotated on EMS. These were excluded from further analysis, leaving 99 programs. Of these, 91 (92%) reported no injuries. One EM resident died in a helicopter crash in 1985. Seven other injury events were reported: 1) facial lacerations, rib fractures, and a shoulder injury in an ambulance accident; 2) an open finger fracture (crushed by a backboard); 3) contusions and a concussion when an ambulance was struck by a fire engine; 4) a groin pull sustained while entering a helicopter; 5) bilateral metatarsal fractures in a fall; 6) rib fractures, a pneumothorax, and a concussion in an ambulance accident; and 7) "minor injuries" sustained in a crash while responding to a scene in a program-owned response vehicle. Actions taken at residency programs to reduce the risk of injury include the use of ballistic vests (four programs), requiring helmets on flights (five programs), and changing flight experience from mandatory to optional (two programs). Ten programs (10%) reported using ground scene safety lectures, and nine programs (15% of those offering flights) reported various types of flight safety instruction. Sixty-nine programs (70%) reported no formal field safety training or other active steps to increase resident safety on EMS rotations.
Injuries sustained by EM residents during EMS rotations are uncommon but nontrivial, with several serious injuries and one fatality reported. The majority of EM residency programs have no formal safety training programs for EMS rotations.
研究急诊医学（EM）住院医师在急救医疗服务（EMS）轮转期间受伤的发生率及性质，以及EM住院医师培训项目为提高住院医师在现场活动中的安全性所采取的措施。
向所有114名美国EM住院医师培训项目主任邮寄了一份包含8个问题的调查问卷，并在首次邮寄8周后向未回复者再次邮寄。
共收回105份调查问卷（92%）。6份调查问卷来自新的项目，其住院医师尚未参加EMS轮转。这些问卷被排除在进一步分析之外，剩余99个项目。其中，91个项目（92%）报告无人员受伤。1985年，一名EM住院医师死于直升机坠毁事故。还报告了其他7起受伤事件：1）在一次救护车事故中面部撕裂伤、肋骨骨折和肩部受伤；2）手指开放性骨折（被背板挤压）；3）救护车被消防车撞击时出现挫伤和脑震荡；4）进入直升机时腹股沟拉伤；5）跌倒导致双侧跖骨骨折；6）在一次救护车事故中肋骨骨折、气胸和脑震荡；7）乘坐项目所属应急车辆前往现场途中发生碰撞时受“轻伤”。住院医师培训项目为降低受伤风险采取的措施包括使用防弹背心（4个项目）、飞行时要求佩戴头盔（5个项目）以及将飞行经历从强制改为可选（2个项目）。10个项目（10%）报告开展了地面现场安全讲座，9个项目（提供飞行服务项目中的15%）报告提供了各类飞行安全指导。69个项目（70%）报告未进行正式的现场安全培训或采取其他积极措施来提高住院医师在EMS轮转期间的安全性。
EM住院医师在EMS轮转期间受伤虽不常见但并非微不足道，报告了数起重伤和1例死亡。大多数EM住院医师培训项目没有针对EMS轮转的正式安全培训项目。
