We have tried in a recently published systematic review(World J of Surg 2014; 38: 322-329) to study the educational value of advanced trauma life support(ATLS) courses and whether they improve survival of multiple tra...We have tried in a recently published systematic review(World J of Surg 2014; 38: 322-329) to study the educational value of advanced trauma life support(ATLS) courses and whether they improve survival of multiple trauma patients. This Frontier article summarizes whatwe have learned and reflects on future perspectives in this important area. Our recently published systematic review has shown that ATLS training is very useful from an educational point view. It significantly increased knowledge, and improved practical skills and the critical decision making process in managing multiple trauma patients. These positive changes were evident in a wide range of learners including undergraduate medical students and postgraduate residents from different subspecialties. In contrast, clear evidence that ATLS training reduces trauma death is lacking. It is obvious that it is almost impossible to perform randomized controlled trials to study the effect of ATLS courses on trauma mortality. Studying factors predicting trauma mortality is a very complex issue. Accordingly, trauma mortality does not depend solely on ATLS training but on other important factors, like presence of well-developed trauma systems including advanced pre-hospital care. We think that the way to answer whether ATLS training improves survival is to perform large prospective cohort studies of high quality data and use advanced statistical modelling.展开更多
Objective： Since appropriate and time- table methods in trauma care have an important impact on patients＇ outcome, we evaluated the effect of Advanced Trauma Life Support （ATLS） program on medical interns＇ perfor...Objective： Since appropriate and time- table methods in trauma care have an important impact on patients＇ outcome, we evaluated the effect of Advanced Trauma Life Support （ATLS） program on medical interns＇ performance in simulated trauma patient management. Methods： A descriptive and analytical study before and after the training was conducted on 24 randomly se- lected undergraduate medical interns from Imam Reza Hospital in Mashhad, Iran. On the first day, we assessed in- terns＇ clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre- and post- ATLS periods, were compared through SPSS version 15.0 software. P values less than 0.05 were considered statistically significant. Results： Our findings showed that interns＇ ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns＇ clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations （P〈0.001, P=0.016 and P=0.01 respectively）. Conclusion： ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.展开更多
目的探讨儿童创伤生命支持(pediatric trauma life support,PTLS)培训课程对提高儿童创伤急救能力的作用。方法采用国际创伤生命支持学会的PTLS课程对从事儿童创伤急救的医护人员进行培训,培训分为理论课和实践课,注重于提高学员的现场...目的探讨儿童创伤生命支持(pediatric trauma life support,PTLS)培训课程对提高儿童创伤急救能力的作用。方法采用国际创伤生命支持学会的PTLS课程对从事儿童创伤急救的医护人员进行培训,培训分为理论课和实践课,注重于提高学员的现场判断能力和急救技能。结果培训后学员的理论测试成绩较培训前提高,合格率、优秀率也有提高,差异均有统计学意义(P<0.01)。学员的技能考核和仿真模拟考核均达到合格,其中优秀率依次为,转运固定技能42.62%,初级、高级气道管理81.97%,休克判断和处理70.49%,仿真模拟考核72.13%。院内组的培训前理论成绩显著高于院前组(P<0.01),培训后院内组仍高于院前组,差异有统计学意义(P<0.01)。结论经PTLS培训后,学员的理论、实践和综合救治能力得到提高,团队合作精神得到加强。展开更多
目的探讨院外创伤生命支持(prehospital trauma life support,PHTLS)课程在军队医院医护人员战创伤救治训练中的应用价值。方法选取2019年1—12月在解放军总医院第六医学中心参加PHTLS培训的医护人员为研究对象,分析培训前后考试成绩和...目的探讨院外创伤生命支持(prehospital trauma life support,PHTLS)课程在军队医院医护人员战创伤救治训练中的应用价值。方法选取2019年1—12月在解放军总医院第六医学中心参加PHTLS培训的医护人员为研究对象,分析培训前后考试成绩和心率、体温、收缩压3项生理指标变化,并采用问卷调查的方法分析培训前后问卷调查评分变化。结果参训人员78人,其中医生64人,占82.1%,护理人员14人,占17.9%,5年以上临床工作经验参训人员占70.5%,经理论和模拟病例考核有72人通过,通过率92%。培训考核结束后体温、心率和收缩压3项生理指标均不同程度的升高(P<0.01),问卷调查培训前平均评分(50.1±3.468)分,培训后及培训后半年平均评分为(66.2±2.46)、(64.2±1.835)分,均高于培训前(P<0.01)。结论PHTLS培训能增加医护人员创伤救治知识,提高救护技术水平,增强信心,增加团队配合经验,对于军队医院医护人员战创伤救治训练有一定价值。展开更多
体外生命支持(extracorporeal life support,ECLS)是对严重呼吸衰竭、循环衰竭甚至休克患者最后的治疗措施,能有效、安全的进行治疗,并取得一定治疗效果。但目前应用范围较局限,且发展不完善。文中就ECLS历史背景、临床应用及存在问题...体外生命支持(extracorporeal life support,ECLS)是对严重呼吸衰竭、循环衰竭甚至休克患者最后的治疗措施,能有效、安全的进行治疗,并取得一定治疗效果。但目前应用范围较局限,且发展不完善。文中就ECLS历史背景、临床应用及存在问题、发展前景作一综述。展开更多
BACKGROUND Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury,although elbow dislocation or fracture of the ulna and radius may occur separately.CASE SUMMARY We ...BACKGROUND Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury,although elbow dislocation or fracture of the ulna and radius may occur separately.CASE SUMMARY We report the case of a 37-year-old woman with open(IIIA)fracture of the right distal humerus with multiple shaft fractures of the ipsilateral radius and ulna with a history of falling from a height of almost 20 m from a balcony.After providing advanced trauma life support,damage control surgery was performed to debride the arm wound and temporarily stabilize the right upper limb with external fixators in the emergency operating room.Subsequently,one-stage internal fixation of multiple fractures was performed with normal values of biochemical indicators and reduction in limb swelling.The patient achieved good outcome at the 7 mo follow-up.CONCLUSION One-or two-stage treatment must be performed according to the type of injury;we efficiently used the“damage control principle.”展开更多
文摘We have tried in a recently published systematic review(World J of Surg 2014; 38: 322-329) to study the educational value of advanced trauma life support(ATLS) courses and whether they improve survival of multiple trauma patients. This Frontier article summarizes whatwe have learned and reflects on future perspectives in this important area. Our recently published systematic review has shown that ATLS training is very useful from an educational point view. It significantly increased knowledge, and improved practical skills and the critical decision making process in managing multiple trauma patients. These positive changes were evident in a wide range of learners including undergraduate medical students and postgraduate residents from different subspecialties. In contrast, clear evidence that ATLS training reduces trauma death is lacking. It is obvious that it is almost impossible to perform randomized controlled trials to study the effect of ATLS courses on trauma mortality. Studying factors predicting trauma mortality is a very complex issue. Accordingly, trauma mortality does not depend solely on ATLS training but on other important factors, like presence of well-developed trauma systems including advanced pre-hospital care. We think that the way to answer whether ATLS training improves survival is to perform large prospective cohort studies of high quality data and use advanced statistical modelling.
文摘Objective： Since appropriate and time- table methods in trauma care have an important impact on patients＇ outcome, we evaluated the effect of Advanced Trauma Life Support （ATLS） program on medical interns＇ performance in simulated trauma patient management. Methods： A descriptive and analytical study before and after the training was conducted on 24 randomly se- lected undergraduate medical interns from Imam Reza Hospital in Mashhad, Iran. On the first day, we assessed in- terns＇ clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre- and post- ATLS periods, were compared through SPSS version 15.0 software. P values less than 0.05 were considered statistically significant. Results： Our findings showed that interns＇ ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns＇ clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations （P〈0.001, P=0.016 and P=0.01 respectively）. Conclusion： ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.
文摘目的探讨儿童创伤生命支持(pediatric trauma life support,PTLS)培训课程对提高儿童创伤急救能力的作用。方法采用国际创伤生命支持学会的PTLS课程对从事儿童创伤急救的医护人员进行培训,培训分为理论课和实践课,注重于提高学员的现场判断能力和急救技能。结果培训后学员的理论测试成绩较培训前提高,合格率、优秀率也有提高,差异均有统计学意义(P<0.01)。学员的技能考核和仿真模拟考核均达到合格,其中优秀率依次为,转运固定技能42.62%,初级、高级气道管理81.97%,休克判断和处理70.49%,仿真模拟考核72.13%。院内组的培训前理论成绩显著高于院前组(P<0.01),培训后院内组仍高于院前组,差异有统计学意义(P<0.01)。结论经PTLS培训后,学员的理论、实践和综合救治能力得到提高,团队合作精神得到加强。
文摘目的探讨院外创伤生命支持(prehospital trauma life support,PHTLS)课程在军队医院医护人员战创伤救治训练中的应用价值。方法选取2019年1—12月在解放军总医院第六医学中心参加PHTLS培训的医护人员为研究对象,分析培训前后考试成绩和心率、体温、收缩压3项生理指标变化,并采用问卷调查的方法分析培训前后问卷调查评分变化。结果参训人员78人,其中医生64人,占82.1%,护理人员14人,占17.9%,5年以上临床工作经验参训人员占70.5%,经理论和模拟病例考核有72人通过,通过率92%。培训考核结束后体温、心率和收缩压3项生理指标均不同程度的升高(P<0.01),问卷调查培训前平均评分(50.1±3.468)分,培训后及培训后半年平均评分为(66.2±2.46)、(64.2±1.835)分,均高于培训前(P<0.01)。结论PHTLS培训能增加医护人员创伤救治知识,提高救护技术水平,增强信心,增加团队配合经验,对于军队医院医护人员战创伤救治训练有一定价值。
基金Supported by Discipline Construction Project of Characteristic Clinic of Pudong New Area Health Commission,China,No.PWYts2018-03Research Grant for Health Science and Technology of Pudong Health and Family Planning Commission of Shanghai,China,No.PW2020A-28Top-notch Talent Training Program of Pudong Gongli Hospital,China,No.GLRb2020-04.
文摘BACKGROUND Floating elbow along with ipsilateral multiple segmental forearm fracture is a rare and high-energy injury,although elbow dislocation or fracture of the ulna and radius may occur separately.CASE SUMMARY We report the case of a 37-year-old woman with open(IIIA)fracture of the right distal humerus with multiple shaft fractures of the ipsilateral radius and ulna with a history of falling from a height of almost 20 m from a balcony.After providing advanced trauma life support,damage control surgery was performed to debride the arm wound and temporarily stabilize the right upper limb with external fixators in the emergency operating room.Subsequently,one-stage internal fixation of multiple fractures was performed with normal values of biochemical indicators and reduction in limb swelling.The patient achieved good outcome at the 7 mo follow-up.CONCLUSION One-or two-stage treatment must be performed according to the type of injury;we efficiently used the“damage control principle.”
