摘要
目的调查紧急医学救援人员在救援现场进行初级创伤救治(PTC)的能力,为应急培训演练提供循证医学证据。方法模拟突发公共性事件批量危重伤员救治现场,对四川省市(卅)、县级救援人员进行横断面调查,对其初级创伤救治表现进行测评分析。结果①287名救援演练人员纳入调查。②初级创伤救治能力总体得分中位数57.14(53.57,82.14);各维度得分:初级评估42.86(42.86,85.71),组织协同58.33(50,75),循环管理70.59(64.71,76.47),呼吸管理36.36(27.27,81.82),次级评估77.78(66.67,88.89)。各职业分层:临床医生83.93(82.14,87.50),护士87.50(82.14,89.29),医技53.57(50,57.59),公卫医生53.57(50,57.14),卫生管理55.36(50,57.14)。各职称分层:初级63.39(53.57,83.93),中级58.93(53.57,83.93),高级55.36(50,58.93)。③各维度间测评得分比较,初级评估与分配任务、循环管理、次级评估比较,组织协同与循环管理、呼吸管理、次级评估比较,循环管理与呼吸管理、次级评估比较,呼吸管理与次级评估比较;临床医生、护士与医技、公卫医生、卫生管理比较,初级、中级与高级比较,场P<0.05,差异有统计学意义。结论模拟灾害批量危重伤员的救援场景,对救援人员的PTC技能行为进行数据化考评,为灾难救援演练提供一种数据考评模式。救援人员现场PTC总体能力一般;初级评估和呼吸管理维度能力较差,应重点提升;组织协同维度能力一般,应进行强化训练;高级职称人员,医技、公卫医生及卫生管理人员是重点培训人群。
Objective The aim of this research is to investigate the ability of emergency staff to perform primary trauma care at the rescue site,and to provide evidence-based medical evidence for emergency training exercises.Methods Under circumstance of a simulative rescuing scene of massive injured people in a sudden emergency event,a cross-sectional survey was implemented in emergency medical rescue staff from city and county level of Sichuan Province.These staff were evaluated for the competence and correction rate score of primary trauma care.Results①Total 287 staff of emergency rescuers were included for investigation.②The Median(P25,P75)of overall correction rate score of primary trauma care was 57.14(53.57,82.14),the score of each dimension was:evaluate patients 42.86(42.86,85.71),mission assignment 58.33(50,75),circulation management 70.59(64.71,76.47),respiratory management 36.36(27.27,81.82),re-evaluation 77.78(66.67,88.89).The correction rate score was 83.93(82.14,87.50)in clinician,87.50(82.14,89.29)in nurse,53.57(50,57.59)in medical technology staff,53.57(50,57.14)in public health staff,55.36(50,57.14)in administrative staff.The correction rate score was 63.39(53.57,83.93)in junior rank,58.93(53.57,83.93)in intermediate rank,55.36(50,58.93)in senior rank.(3)There were statistically significant differences among dimensions below:evaluate patients vs.mission assignment/circulation management/re-evaluation,mission assignment vs.circulation management/respiratory management/re-evaluation,circulation management vs.respiratory management/re-evaluation,respiratory management vsre-evaluation.There were statistically significant differences among staffs:clinician/nurse vs.medical technology staff-public health staff-administrative staff,junior/intermediate ranks vs.senior rank.All P<0.05.Conclusions The general ability of primary trauma care of rescue staff in this survey is ordinary.It is necessary to train those with insufficient abilities,focus on evaluate patients and respiratory management dimensions.This re・search could provide a path to check the ability of primary trauma care at the rescue site in emergency can exercises.
作者
陈康
杨艳
张建成
李鑫
曾俊
江华
CHEN Kang;YANG Yan;ZHANG Jiancheng;Li Xin;ZENG Jun;JIANG Hua(Emergency Department of Sichuan Provincial People's Hospital,University of Electronic Science and Technology of China,Chengdu610072,China)
出处
《中国急救复苏与灾害医学杂志》
2020年第1期107-111,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
四川省科技支撑计划项目(编号:2015SZ0110)。
关键词
现场救援
情景模拟
初级创伤救治
横断面研究
On-site rescue
Simulation
Primary trauma care
Cross-sectional survey