创伤院前救护能力现状及延时现场救护知识和能力准备-多中心横断面调研

The capacity of pre-hospital trauma care and cognition for prolonged field care among military and civilian hospital medical personnel:A multicenter cross-sectional study

目的了解我国军、地医院创伤院前救护能力现状及延时现场救护(prolonged field care,PFC)认知及能力准备情况,为相关培训提供参考。方法2021年2月—6月,采用分层抽样和便利抽样相结合的方法,选取东北、西南、中部、东南以及珠三角地区242名军队及地方医护人员,采用自行设计的《中国创伤院前急救及延时现场救护(PFC)认知情况调查问卷》,借助于问卷星平台进行多中心横断面调查。结果(1)部队三甲医院年均院前救护任务显著多于地方二甲医院(P<0.05),道路交通伤在所有伤型中占比最高;(2)“途中持续监护和复苏预案”是制定最多的院前救护预案,“转运时间过长”是反映最多的问题;(3)PFC知晓率仅为35.1%;(4)“现场处理能力”和“复杂伤情评估”被分别认为是军、地医院创伤院前急救培训中最急需和最缺少的能力。结论当前我国军、地医院救护人员对创伤院前急救措施的掌握情况不容乐观,对各类预案了解不足,PFC概念知晓度普遍较低,缺乏复杂伤情评估和决策能力,亟待完善培训策略,提升整体创伤院前救护能力。

Objective To evaluate the pre-hospital trauma care capacity of Chinese military and civilian medical personnel,and their knowledge and preparations for prolonged field care(PFC),in order to provide reference for related trainings.Methods This multicenter cross-sectional survey was conducted from Feb.to Jun.2021,on 242 medical personnel from civilian or military hospitals located in the Northeast,Southeast,Southwest,Central,and Pearl River Delta regions of China using the combined stratified and convenience sampling technique.The respondents finished the self-designed Chinese Pre-hospital Trauma Rescue and PFC Cognition Questionnaire via the Sojump platform.Results(1)Medical personnel at military tertiary hospitals performed considerably more yearly pre-hospital rescues than those in local secondary hospitals(P<0.05),with road traffic accidents being the leading cause of injuries.(2)“Transport monitoring and resuscitation plan”was mostly set among all pre-hospital emergency plans;“excessive transfer time”was the mostly reported issue.(3)The PFC cognition rate was only 35.1%.(4)“On-site care”was mostly desired in training and“assessment skills of multiple injuries”were the weakest capability.Conclusion It is found that among the military and civilian medical personnel,the pre-hospital emergency care is fragmented,the rescue plans are poorly understood,the PFC concept is rarely known,and the skills to assess and manage complicated injuries are largely lacked.There is an urgent need to strengthen the training strategies for pre-hospital trauma care to increase the comprehensive capability.