@2024 Afarand., IRAN
ISSN: 2228-5468 Education Strategies in Medical Sciences 2013;6(1):55-59
ISSN: 2228-5468 Education Strategies in Medical Sciences 2013;6(1):55-59
Fitness of Function and Education of Pre-hospital Emergency Technicians in Dealing with Trauma Patients
ARTICLE INFO
Article Type
Original ResearchAuthors
Alimohammadi H. (1)Monfaredi B. (1)
Amini A. (1)
Derakhshanfar H. (1)
Hatamabadi H. (2)
Bidari Zerehpoosh F. (*)
(*) Pathology Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
(1) Emergency Medicine Department, Imam Husain Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
(2) Emergency Medicine Department, “Faculty of Medicine” & “Safety Promotion and Injury Prevention Research Center”, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Correspondence
Address: Pathology Department, Loghman Hakim Hospital, Kamali Street, South Kargar Strret, Tehran, Iran.Phone: +982155419423
Fax: +982155419423
farahnazbidari@yahoo.com
Article History
Received: January 13, 2013Accepted: March 9, 2013
ePublished: March 10, 2013
ABSTRACT
Aims
Pre-hospital cares (PHC) of trauma emergency patients have special characteristics and diagnostic and the rapeutical measures carried out before the patients’ arrival to hospital play a considerable role in reducing the mortality and improving their outcomes. The present study was an attempt to evaluate the accuracy of pre-hospital EMS technician performance in Tehran dealing with trauma patients.
Materials & Methods In a cross sectional study, from September 2010 to September 2011, on the traumatic patients transferred by Pre-hospital emergency medical services (EMS), 500 patients were selected using simple achievable sampling method. The study was conducted by checking the mission form, interviewing the pre-hospital technicians and examining the patient to determine the necessary measures done before the arrival to emergency department using checklist. Data was analyzed using paired T-test and Chi-square test in SPSS 18 software.
Findings The mean time interval of contact with Pre-hospital EMS up to the arrival of them to the place of incidence was 9.48±7.71 min (minimum 1 and maximum 100) and the mean time interval of patient’s transfer from the incident scene to the hospital was 35.99±18.53 min (minimum 5 and maximum 137). Technician’s adverse course of actions regarding the cervical spine immobilization (10.3%), spinal cord immobilization (16.6%), organ fracture immobilization (14%), IV (9.9%) and bleeding control (33.6%) were observed.
Conclusion Pre-hospital technicians have a desirable diagnosis and performance in establishing IV line, cervical spine immobilization, spinal cord immobilization, organ fracture immobilization and bleeding control. Moreover, they are weak regarding the diagnosis and support of oxygenation and removal of foreign body.
Materials & Methods In a cross sectional study, from September 2010 to September 2011, on the traumatic patients transferred by Pre-hospital emergency medical services (EMS), 500 patients were selected using simple achievable sampling method. The study was conducted by checking the mission form, interviewing the pre-hospital technicians and examining the patient to determine the necessary measures done before the arrival to emergency department using checklist. Data was analyzed using paired T-test and Chi-square test in SPSS 18 software.
Findings The mean time interval of contact with Pre-hospital EMS up to the arrival of them to the place of incidence was 9.48±7.71 min (minimum 1 and maximum 100) and the mean time interval of patient’s transfer from the incident scene to the hospital was 35.99±18.53 min (minimum 5 and maximum 137). Technician’s adverse course of actions regarding the cervical spine immobilization (10.3%), spinal cord immobilization (16.6%), organ fracture immobilization (14%), IV (9.9%) and bleeding control (33.6%) were observed.
Conclusion Pre-hospital technicians have a desirable diagnosis and performance in establishing IV line, cervical spine immobilization, spinal cord immobilization, organ fracture immobilization and bleeding control. Moreover, they are weak regarding the diagnosis and support of oxygenation and removal of foreign body.
CITATION LINKS
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[15] Smith J, Bricker S, Putnam B. Tissue oxygen saturation predicts the need for early blood transfusion in trauma patients. Am Surg. 2008;74(10):1006-11.
[16]Gaarder C, Naess PA, Frischknecht Christensen E, Hakala P, Handolin L, Heier HE, et al. Scandinavian guidelines: The massively bleeding patient. Scand J Surg. 2008;97:15-36.
[17] Trine S, Signe S. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway. Scand J Trauma Resusc Emerg Med. 2011;19:20.
[18]Henry E, Judith R, Carl A. Paramedic intubation errors: Isolated events or symptom of larger problems. Health Affair. 2006;25(2):501-9.
[2]Yeguiayan JM, Garrigue D, Binquet C. Medical prehospital management reduces mortality in severe blunt trauma: a prospective epidemiological study. Crit Care. 2011;15(1):34.
[3]Thomas H. Emergency medical services: Overview and ground transport in Rosen’s. 7th ed. New York: Blackwell Publisher; 2009.
[4]Tintinalli JE, Gabor DJS. Emergency medicine: A comprehensive study guide, 6th ed. New York: McGraw-Hill Professional; 2010.
[5] Marx J, Hockberger R, Walls R. Rosen's emergency medicine; concepts and clinical practice. 7th ed. Amsterdam: Elsevier; 2010.
[6] Brice Jh, Friend kD, Dilbridge TR. Accuracy of EMSrecorded patient demographic data. Prehosp Emerg Care. 2008;12(2):187-91.
[7] Gausche-Hill M. Ensuring quality in prehospital airway management: Department of emergency medicine. Care Opin Anaesthesiol. 2003;16(2):173-81.
[8] Moscat R, Billittier AJ, Marshall B, Fincher M, Jehle D. Blood loss estimation by out-of-hospital emergency care providers: Department of emergency medicine. Prehosp Emerg Care. 1999;3(3):239-42.
[9] Gonzalez RP, Cummings GR, Mulekar MS, Harlan SM. Improving rural emergency medical service response time with global positioning system navigation. J Trauma. 2009;67(5):899-902.
[10] Boergerhoff LA, Gerberich SG, Anderson A, Kochevar L, Waller L. Out-of-hospital violence injury surveillance: Quality of data collection. Ann Emerg Med. 1999;34:745- 50.
[11]Wyatt J. Acquisition and use of clinical data for audit and research. J Eval Clin Pract. 1995;1:15-27.
[12] Kruger AJ, Skogvoll E, Castren M, Kurola J, Lossius HM. Scandinavian pre-hospital physician-manned emergency medical services: Same concept across borders? Resuscitation. 2010;81:427-33.
[13] Newgard CD, Zive D, Jui J, Weathers C, Daya M. Electronic versus manual data processing: Evaluating the use of electronic health records in out-of-hospital clinical research. Acad Emerg Med. 2012;19(2):217-27.
[14] Newgard CD, Zive D, Malveau S, Leopold R, Worrall W, Sahni R. Developing a statewide emergency medical services database linked to hospital outcomes: A feasibility study. Prehosp Emerg Care. 2011;15(3):303-19.
[15] Smith J, Bricker S, Putnam B. Tissue oxygen saturation predicts the need for early blood transfusion in trauma patients. Am Surg. 2008;74(10):1006-11.
[16]Gaarder C, Naess PA, Frischknecht Christensen E, Hakala P, Handolin L, Heier HE, et al. Scandinavian guidelines: The massively bleeding patient. Scand J Surg. 2008;97:15-36.
[17] Trine S, Signe S. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway. Scand J Trauma Resusc Emerg Med. 2011;19:20.
[18]Henry E, Judith R, Carl A. Paramedic intubation errors: Isolated events or symptom of larger problems. Health Affair. 2006;25(2):501-9.