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Teuben MPJ, Löhr N, Shehu A, Berk T, Jensen KO, Mikova E, Brüesch M, Müller S, Pfeifer R, Mica L, Pape HC, Sprengel K. The value of pre-hospital trauma life support courses for medical personnel-a questionnaire study. Front Med (Lausanne) 2024; 11:1345310. [PMID: 38646559 PMCID: PMC11026852 DOI: 10.3389/fmed.2024.1345310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/30/2024] [Indexed: 04/23/2024] Open
Abstract
Background The aim of the study was to determine the impact that PHTLS® course participation had on self-confidence of emergency personnel, regarding the pre-hospital treatment of patients who had suffered severe trauma. Furthermore, the goal was to determine the impact of specific medical profession, work experience and prior course participation had on the benefits of PHTLS® training. Methods A structured questionnaire study was performed. Healthcare providers from local emergency services involved in pre-hospital care in the metropolitan area of Zurich (Switzerland, Europe) who completed a PHTLS® course were included. Altered self-confidence, communication, and routines in the treatment of severe trauma patients were examined. The impact of prior course participation, work experience and profession on course benefits were evaluated. Results The response rate was 76%. A total of 6 transport paramedics (TPs), 66 emergency paramedics (EPs) and 15 emergency doctors (EDs) were included. Emergency paramedics had significantly more work experience compared with EDs (respectively 7.1 ± 5.7 yrs. vs. 4.5 ± 2.1 yrs., p = 0.004). 86% of the participants reported increased self-confidence in the pre-hospital management of severe trauma upon PHTLS® training completion. Moreover, according to 84% of respondents, extramural treatment of trauma changed upon course completion. PHTLS® course participants had improved communication in 93% of cases. This was significantly more frequent in EPs than TPs (p = 0.03). Multivariable analysis revealed emergency paramedics benefit the most from PHTLS® course participation. Conclusion The current study shows that PHTLS® training is associated with improved self-confidence and enhanced communication, with regards to treatment of severe trauma patients in a pre-hospital setting, among medical emergency personnel. Additionally, emergency paramedics who took the PHTLS® course improved in overall self-confidence. These findings imply that all medical personal involved in the pre-hospital care of trauma patients, in a metropolitan area in Europe, do benefit from PHTLS® training. This was independent of the profession, previous working experience or prior alternative course participation.
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Affiliation(s)
| | - Nikolaus Löhr
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Alba Shehu
- Department of Trauma, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Till Berk
- Department of Trauma, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Kai Oliver Jensen
- Department of Trauma, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Ester Mikova
- University of Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Martin Brüesch
- Institute of Anaesthesiology, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | | | - Roman Pfeifer
- Department of Trauma, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Ladislav Mica
- Department of Trauma, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Hans Christoph Pape
- Department of Trauma, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Kai Sprengel
- Department of Trauma, University Hospital Zurich, University of Zurich, Zürich, Switzerland
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Rajeh Saifan A, Al-Jaafreh A, Mosleh SM, Mohammad Alsaraireh M, Al-Yateem N, Refaat Ahmed F, Arsyad Subu M. The lived experiences of healthcare professionals working in pre-hospital emergency services in Jordan: A qualitative exploratory study. Int Emerg Nurs 2024; 73:101405. [PMID: 38266322 DOI: 10.1016/j.ienj.2023.101405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 12/12/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Globally, injuries account for 9% of all deaths, with road accidents contributing to approximately a quarter of these fatalities. A major concern is the inadequacy of pre-hospital care (emergency medical services provided before arrival at a hospital) and delays in transportation to medical facilities, identified as leading causes of preventable injury-related deaths. This study explores the experiences of emergency health professionals (EHPs) in peri-hospital services (emergency medical services provided immediately upon arrival and within the hospital setting). METHODS A qualitative exploratory design, underpinned by Van Manen's (1990) descriptive phenomenological principles, was used. Thirty EHPs from five central and southern Jordanian emergency departments were purposefully sampled, including physicians, nurses, and paramedics from both emergency departments and pre-hospital services. RESULTS Two primary themes emerged: (1) In Search of Clarity: The Unsettled Journey of Pre-hospital Emergency Care Providers; (2) Frustrations on the Frontline: Role Ambiguity and Emotional Exhaustion in Trauma Care, with EHPs reporting fluid and unclear roles, physical and verbal abuse, and limited authority in critical interventions. CONCLUSION The study highlights several service lapses in peri-hospital care that negatively impact healthcare professionals, posing risks to patient safety. These findings urge decision-makers to devise actionable strategies to rectify these deficiencies, enhancing care quality and thereby decreasing injury-induced mortality and morbidity.
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Affiliation(s)
- Ahmad Rajeh Saifan
- Associate Professor of Nursing, Nursing Department, Applied Science Private University, Amman, Jordan.
| | - Ali Al-Jaafreh
- Paramedics Trainer, Civil Defense College, Amman, Jordan
| | - Sultan M Mosleh
- Faculty of Health Sciences, Higher Colleges of Technology, Fujairah PO Box 1626, United Arab Emirates; Faculty of Nursing, Mutah University, Karak, Jordan.
| | - Mahmoud Mohammad Alsaraireh
- Princess Aisha Bint Al Hussein College for Nursing and Health Sciences, Al Hussaein Bin Talal University, Maan, Jordan.
| | - Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, United Arab Emirates; Adjunct Associate Professor, Charles Sturt University, Australia.
| | - Fatma Refaat Ahmed
- Department of Nursing, College of Health Sciences, University of Sharjah, United Arab Emirates; Criticl Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
| | - Muhammad Arsyad Subu
- Department of Nursing, College of Health Sciences, University of Sharjah, United Arab Emirates; Faculty of Nursing and Midwifery, Universitas Binawan, Jakarta, Indonesia.
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Kamgar Amaleh MH, Heydari S, Nazari P, Bakhshi F. Evaluating the effectiveness of the pre‑hospital trauma life support (PHTLS) program for the management of trauma patients in the pre-hospital emergency based on Kirkpatrick's evaluation model. Int J Emerg Med 2024; 17:13. [PMID: 38287277 PMCID: PMC10823684 DOI: 10.1186/s12245-024-00589-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/13/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Pre-hospital trauma life support (PHTLS) training courses have been developed and widely adopted to enhance the proficiency of pre-hospital personnel in handling trauma patients. The objective of this study was to assess the effectiveness of the educational program for managing trauma patients in the pre-hospital emergency setting, utilizing Kirkpatrick's educational evaluation model. METHODS This is an observational approach, consisting of four sub-studies. The PHTLS course was conducted over a 2-day period, encompassing both theoretical and practical components. For this study, we selected pre-hospital personnel from three emergency aid stations using a convenient sampling method. These personnel underwent their first-ever PHTLS course training, and we subsequently analyzed the effectiveness of the training program using Kirkpatrick's four levels of evaluation: satisfaction, learning, behavior, and results. RESULTS The study conducted on Kirkpatrick's first-level analysis revealed that participants expressed a high level of satisfaction with the quality of all aspects of the course. Moving on to the second and third levels, namely learning and behavior, significant improvements were observed in the average scores of various skills that were examined both immediately after the course and 2 months later (P < 0.05). However, when it comes to the fourth level and the impact of the course on indicators such as mortality rate and permanent disability, no significant changes were observed even after an average of 3 months since the course was introduced. CONCLUSION The implementation of PHTLS has been linked to the enhancement of participants' skills in treating trauma patients, leading to the application of acquired knowledge in real-life scenarios and a positive change in participants' behavior. The evaluation of PHTLS courses in Iran, as in other countries, highlights the need for specialized training in pre-hospital trauma care. To ensure the continued effectiveness of the PHTLS course, it is advisable for managers and policymakers to encourage regular participation of PHTLS employees in the program.
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Affiliation(s)
- Mohammad Hadi Kamgar Amaleh
- International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Emergency Nursing, Larestan University of Medical Sciences, Larestan, Iran
| | - Sara Heydari
- Department of Medical Education, Medical Education and Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Peyman Nazari
- Emergency Nursing, Gerash University of Medical Sciences, Gerash, Iran
| | - Fatemeh Bakhshi
- Nursing, Research Center for Nursing and Midwifery Care, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, 8916877443, Iran.
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Al-Jaafreh A, Saifan AR, Mosleh SM, Al-Yateem N, Al-Momani MM. Experience of Health Professionals in Caring for Patients With Chest Trauma: A Qualitative Study. Dimens Crit Care Nurs 2023; 42:153-162. [PMID: 36996360 DOI: 10.1097/dcc.0000000000000579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND The variation in the implementation of chest trauma (CT) management's guidelines led to inconsistent and mixed experiences toward CT management by the health care team. Moreover, there is a scarcity of studies exploring factors that enhance CT management experiences worldwide and in Jordan. OBJECTIVES The aims of this study were (1) to explore emergency health professionals' attitudes and experiences toward CT management and (2) to understand factors that affect the care for patients with CTs among emergency health professionals. METHODS A qualitative exploratory approach was adopted in this study. Individual, semistructured, face-to-face interviews were conducted with 30 emergency health professionals (physicians, nurses, and paramedics) from government emergency departments, military, private hospitals, and paramedics from the Civil Defense in Jordan. RESULTS The results showed that emergency health professionals had negative attitudes toward caring for patients with CTs due to a lack of knowledge and clarity in their job description and duties assigned to them. Moreover, some organizational and training factors were discussed for their impact on the attitudes of emergency health professionals toward caring for patients with CTs. CONCLUSIONS Lack of knowledge, absence of clear guidelines and job descriptions for dealing with traumas, and lack of continuous training on caring for patients with CTs were the most common reasons for negative attitudes. These findings can assist stakeholders, managers, and organizational leaders in understanding health care challenges and provoke a more focused strategic plan to diagnose and treat patients with CT.
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Häske D, Gross Z, Atzbach U, Bernhard M, Gather A, Hoedtke J, Hossfeld B, Schele S, Münzberg M. Comparison of manual statements from out-of-hospital trauma training programs and a national guideline on treatment of patients with severe and multiple injuries. Eur J Trauma Emerg Surg 2021; 48:2207-2217. [PMID: 34426883 DOI: 10.1007/s00068-021-01768-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Training programs help establish evidence-based knowledge in prehospital emergency care. This study aimed to compare manual statements from prehospital trauma training programs and evidence-based guidelines on treatment of patients with severe and multiple injuries. METHODS A systematic comparison with the primary endpoint of the highest grades of recommendation (GoR A, "must") of the current version of the German guidelines and recent recommendations of the prehospital trauma training programs International Trauma Life Support (ITLS), Prehospital Trauma Life Support (PHTLS), and Traumamanagement® (TM) based on their official textbooks was done. The recommendations were categorized as agreement or minor or major variation. The comparison was made using a rating system by experts who were blinded to the training programs. If the consensus strength of the experts was < 75%, affected statements were finalized in a Delphi procedure. RESULTS Overall, 92 statements were compared. Fleiss-kappa of the first rating was 0.385 (p < 0.001, 95% CI: 0.376-0.393). Finally, comparable recommendations of the guideline with the training programs in principle agree with the statement of the guidelines were > 90% for all programs. The agreement with GoR A recommendations and each course program were 33.9%, 30.6%, and 35.5% (ITLS, PHTLS, and TM, respectively), p = 0.715. CONCLUSIONS Despite small differences, the training programs showed high degrees of compliance with the guidelines and international agreement with some minor differences. Furthermore, the results did not allow any conclusions regarding the quality of the courses, the didactic methodology, and local adaptability. The practical implementation of the courses is probably even higher and closer to the guidelines.
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Affiliation(s)
- David Häske
- Center of Public Health and Health Services Research, University Hospital Tübingen, Tübingen, Germany.,Emergency Medical Service, German Red Cross, Reutlingen, Germany
| | - Zeno Gross
- Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen, University Hospital Heidelberg, Ludwigshafen, Germany
| | - Ulrich Atzbach
- PHTLS, Academy of the German Association of Emergency Medical Services, Lübeck, Germany
| | - Michael Bernhard
- Emergency Department, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Andreas Gather
- Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen, University Hospital Heidelberg, Ludwigshafen, Germany
| | - Jochen Hoedtke
- Asklepios Klinik Barmbek, Department of Anesthesiology, Intensive and Emergency Medicine, Pain Therapy, Hamburg, Germany.,Trauma Management Network, Training Center Schlump, Hamburg, Germany
| | - Björn Hossfeld
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, HEMS 'Christoph 22', Federal Armed Forces Hospital Ulm, Ulm, Germany
| | - Stephan Schele
- Department of Anesthesiology, Intensive and Emergency Medicine, Klinikverbund Allgäu gGmbH, Immenstadt, Germany.,ITLS-International Trauma Life Support Germany e.V., Mölln, Germany
| | - Matthias Münzberg
- Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen, University Hospital Heidelberg, Ludwigshafen, Germany. .,Department of Rescue and Emergency Medicine, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany.
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Damanabad Z, Dehghannezhad J, Rahmani F, Ghafouri R, Hassankhani H, Dadashzadeh A. Promotion of knowledge, skill, and performance of emergency medical technicians in prehospital care of traumatic patients: An action-research study. ARCHIVES OF TRAUMA RESEARCH 2020. [DOI: 10.4103/atr.atr_112_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Falaki M, Rajaei Ghafouri R, Shams Vahdati S. Problem-Based versus Lecture-Based Method in Pre-hospital Trauma Life Support Training; a Pre-test Post-test Study. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2019; 7:e70. [PMID: 32021981 PMCID: PMC6942920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Masoumeh Falaki
- Emergency Medicine Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Rouzbeh Rajaei Ghafouri
- Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran. ,Corresponding author: Rouzbeh Rajaei Ghafouri; Emergency Medicine Research Team, Tabriz University of Medical Sciences, Daneshgah Street, Tabriz, Iran.
| | - Samad Shams Vahdati
- Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran.
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Kreinest M, Goller S, Rauch G, Gliwitzky B, Frank C, Matschke S, Wölfl CG, Münzberg M. [Parameters influencing the preclinical application of cervical collars]. Unfallchirurg 2019; 120:675-682. [PMID: 27357352 DOI: 10.1007/s00113-016-0207-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The application of cervical collars is a standard procedure in emergency care of trauma patients. It is often observed that the application of cervical collars is performed incorrectly, which may lead to reduced immobilization of the cervical spine. OBJECTIVES The objective of this study was to analyze the practical skills of professional emergency care providers concerning the application of cervical collars. MATERIALS AND METHODS Emergency care professionals (n = 104) were asked to apply a cervical collar to a training doll. Each performance step was assessed separately. Furthermore, personal and occupational data of all study participants were collected using a questionnaire. RESULTS The study participants included professional rescue personnel and emergency physicians. The average occupational experience of all study participants in out-of-hospital emergency care was 11.1 ± 8.9 years. Most participants had already received training on trauma care (61 %) and felt "very confident" in handling a cervical collar (84 %). The application of the cervical collar was performed correctly in 11 % of the performances. The most common error was incorrect size adjustment of the cervical collar (66 %). No association was found between the correct application of the cervical collar and possible parameters of influence, such as working experience in emergency care or participation in trauma courses. CONCLUSIONS Despite pronounced subjective confidence regarding the application of cervical collars, this study shows that there are general deficits in the practical skills of applying cervical collars. Therefore, a critical assessment of the current training contents on the subject of trauma care must be demanded.
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Affiliation(s)
- M Kreinest
- Klinik für Unfallchirurgie und Orthopädie, BG-Unfallklinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland
- PHTLS Germany Research Group, Offenbach/Queich, Deutschland
| | - S Goller
- Klinik für Unfallchirurgie und Orthopädie, BG-Unfallklinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland
- PHTLS Germany Research Group, Offenbach/Queich, Deutschland
| | - G Rauch
- Institut für Medizinische Biometrie und Informatik, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Deutschland
| | - B Gliwitzky
- PHTLS Germany Research Group, Offenbach/Queich, Deutschland
| | - C Frank
- PHTLS Germany Research Group, Offenbach/Queich, Deutschland
- Klinik für Orthopädie und Unfallchirurgie, Klinikum Mittelbaden, Baden-Baden, Deutschland
| | - S Matschke
- Klinik für Unfallchirurgie und Orthopädie, BG-Unfallklinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland
| | - C G Wölfl
- Klinik für Unfallchirurgie und Orthopädie, BG-Unfallklinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland
- PHTLS Germany Research Group, Offenbach/Queich, Deutschland
| | - M Münzberg
- Klinik für Unfallchirurgie und Orthopädie, BG-Unfallklinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland.
- PHTLS Germany Research Group, Offenbach/Queich, Deutschland.
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Häske D, Beckers SK, Hofmann M, Lefering R, Grützner PA, Stöckle U, Papathanassiou V, Münzberg M. Subjective safety and self-confidence in prehospital trauma care and learning progress after trauma-courses: part of the prospective longitudinal mixed-methods EPPTC-trial. Scand J Trauma Resusc Emerg Med 2017; 25:79. [PMID: 28806988 PMCID: PMC5557465 DOI: 10.1186/s13049-017-0426-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/02/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Prehospital trauma care is stressful and requires multi-professional teamwork. A decrease in the number of accident victims ultimately affects the routine and skills and underlines the importance of effective training. Standardized courses, like PHTLS, are established for health care professionals to improve the prehospital care of trauma patients. The aim of the study was to investigate the subjective safety in prehospital trauma care and learning progress by paramedics in a longitudinal analysis. METHODS This was a prospective intervention trial and part of the mixed-method longitudinal EPPTC-trial, evaluating subjective and objective changes among participants and real patient care as a result of PHTLS courses. Participants were evaluated with pre/post questionnaires as well as one year after the course. RESULTS We included 236 datasets. In the pre/post comparison, an increased performance could be observed in nearly all cases. The result shows that the expectations of the participants of the course were fully met even after one year (p = 0.002). The subjective safety in trauma care is significantly better even one year after the course (p < 0.001). Regression analysis showed that (ABCDE)-structure is decisive (p = 0.036) as well as safety in rare and common skills (both p < 0.001). Most skills are also rated better after one year. Knowledge and specific safety are assessed as worse after one year. CONCLUSION The courses meet the expectations of the participants and increase the subjective safety in the prehospital care of trauma patients. ABCDE-structure and safety in skills are crucial. In the short term, both safety in skills and knowledge can be increased, but the courses do not have the power to maintain knowledge and specific subjective safety issues over a year. TRIAL REGISTRATION German Clinical Trials Register, ID DRKS00004713 , registered 14. February 2014.
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Affiliation(s)
- David Häske
- Faculty of Medicine, Eberhard Karls University Tübingen, 72076 Tuebingen, Germany
| | - Stefan K. Beckers
- Department of Anesthesiology, University Hospital RWTH, Aachen, 52074 Aachen, Germany
- Emergency Medical Service, Fire Department, City of Aachen, 52057 Aachen, Germany
| | - Marzellus Hofmann
- Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany
| | - Rolf Lefering
- Institute for Research in Operative Medicine, University of Witten/Herdecke, 51109 Cologne, Germany
| | - Paul A. Grützner
- Department of Trauma Surgery and Orthopedics, BG Hospital Ludwigshafen, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Str. 13, D-67071 Ludwigshafen, Germany
| | - Ulrich Stöckle
- Department of Traumatology and Reconstructive Surgery, BG Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Vassilios Papathanassiou
- Institute of Medical Psychology, University Hospital of the Saarland and Medical Faculty of the University of Saarland, /Saar, 66421 Homburg, Germany
| | - Matthias Münzberg
- Department of Trauma Surgery and Orthopedics, BG Hospital Ludwigshafen, BG Trauma Center Ludwigshafen, Ludwig-Guttmann-Str. 13, D-67071 Ludwigshafen, Germany
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Kreinest M, Gliwitzky B, Grützner PA, Münzberg M. Untersuchung der Anwendbarkeit eines neuen Protokolls zur Immobilisation der Wirbelsäule. Notf Rett Med 2016. [DOI: 10.1007/s10049-016-0154-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Expertise of German paramedics concerning the prehospital treatment of patients with spinal trauma. Eur J Trauma Emerg Surg 2016; 43:371-376. [PMID: 27173645 DOI: 10.1007/s00068-016-0682-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 05/02/2016] [Indexed: 01/21/2023]
Abstract
PURPOSE Spinal immobilization is a standard procedure in emergency medicine. Increasing awareness of complications associated with immobilization of trauma patients leads to controversial discussions in the literature. Current guidelines require to include considerations of accident mechanism, an assessment of the patient's condition and an examination of the spine in the decision-making process if immobilization of the spine should be performed. This requires sound knowledge of assessing these parameters. The aim of the current study is to analyze German paramedics' subjective uncertainty in terms of their prehospital assessment and treatment of patients suffering from spine injuries. METHODS Over a period of 17 months participants in a trauma course were asked to complete a standardized anonymous questionnaire about subjective uncertainty of prehospital assessment and management of spinal trauma before participation in that course. Questions about the frequency of application of different immobilization tools and skills training on spinal immobilization were also asked. RESULTS A total of 465 paramedics were surveyed. The participants did not indicate any uncertainty about the prehospital diagnosis and treatment of spinal injuries. The feeling of confidence was significantly greater in participants who had already attended another course on structured trauma care before. The participants agreed with the statements that standardized algorithms facilitate teamwork and that there is a need for a protocol for the prehospital treatment of spinal injuries. CONCLUSIONS Paramedics do not feel uncertain about the prehospital assessment and treatment of spinal injuries. The feeling of confidence in participants who had already attended a course on the treatment of trauma patients before was significantly higher.
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