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Harada S, Suga R, Suzuki K, Kitano S, Fujimoto K, Narikawa K, Nakazawa M, Ogawa S. Usefulness of Self-Selected Scenarios for Simple Triage and Rapid Treatment Method Using Virtual Reality. J NIPPON MED SCH 2024; 91:99-107. [PMID: 38072419 DOI: 10.1272/jnms.jnms.2024_91-111] [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] [Indexed: 03/12/2024]
Abstract
BACKGROUND Repeated triage training is necessary to maintain and improve the accuracy of simple triage and rapid treatment (START), a popular triage method. Virtual reality (VR) may be more effective than conventional training methods. This study aimed to verify the educational usefulness of START using VR originally developed for students. METHODS A VR was initially developed with a function that allowed students to select the triage procedure and its evaluation. Triage was performed using a simple modified START method, and eight scenarios were developed. The participants included 70 paramedic students classified into VR and live lecture groups. They took a 20-question written test that evaluated their academic ability before the course. After the course, a practical test and a 20-question written test were conducted. The total score of the practical test was 43 points. Triage procedure (1 point), observation and evaluation (1-5 points), and triage categories (1 point) were evaluated in this test. RESULTS The VR and live lecture groups consisted of 33 and 29 participants, respectively. No significant differences were observed pre- and post-test. In the practical test, the median (interquartile range) score was 29 (26-32) and 25 (23-29) for the VR and live lecture groups, respectively, with the VR group scoring significantly higher (P=0.03). CONCLUSION Our results confirmed the educational usefulness of selective VR for active learning of START. Therefore, VR combined with live lectures and simulations would be an optimal educational technique.
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Affiliation(s)
- Satoshi Harada
- Department of Emergency Medical Science, Faculty of Medical and Health Science, Nippon Sport Science University
- Graduate School of Medical and Health Science, Nippon Sport Science University
| | - Ryotaro Suga
- Graduate School of Medical and Health Science, Nippon Sport Science University
- Department of Emergency and Critical Care Medicine, Nippon Medical School
| | - Kensuke Suzuki
- Department of Emergency Medical Science, Faculty of Medical and Health Science, Nippon Sport Science University
- Graduate School of Medical and Health Science, Nippon Sport Science University
| | - Shinnosuke Kitano
- Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital
| | | | - Kenji Narikawa
- Department of Emergency Medical Science, Faculty of Medical and Health Science, Nippon Sport Science University
- Graduate School of Medical and Health Science, Nippon Sport Science University
| | - Mayumi Nakazawa
- Department of Emergency Medical Science, Faculty of Medical and Health Science, Nippon Sport Science University
- Graduate School of Medical and Health Science, Nippon Sport Science University
| | - Satoo Ogawa
- Department of Emergency Medical Science, Faculty of Medical and Health Science, Nippon Sport Science University
- Graduate School of Medical and Health Science, Nippon Sport Science University
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Wespi R, Birrenbach T, Schauber SK, Manser T, Sauter TC, Kämmer JE. Exploring objective measures for assessing team performance in healthcare: an interview study. Front Psychol 2023; 14:1232628. [PMID: 37941756 PMCID: PMC10628530 DOI: 10.3389/fpsyg.2023.1232628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Effective teamwork plays a critical role in achieving high-performance outcomes in healthcare. Consequently, conducting a comprehensive assessment of team performance is essential for providing meaningful feedback during team trainings and enabling comparisons in scientific studies. However, traditional methods like self-reports or behavior observations have limitations such as susceptibility to bias or being resource consuming. To overcome these limitations and gain a more comprehensive understanding of team processes and performance, the assessment of objective measures, such as physiological parameters, can be valuable. These objective measures can complement traditional methods and provide a more holistic view of team performance. The aim of this study was to explore the potential of the use of objective measures for evaluating team performance for research and training purposes. For this, experts in the field of research and medical simulation training were interviewed to gather their opinions, ideas, and concerns regarding this novel approach. Methods A total of 34 medical and research experts participated in this exploratory qualitative study, engaging in semi-structured interviews. During the interview, experts were asked for (a) their opinion on measuring team performance with objective measures, (b) their ideas concerning potential objective measures suitable for measuring team performance of healthcare teams, and (c) their concerns regarding the use of objective measures for evaluating team performance. During data analysis responses were categorized per question. Results The findings from the 34 interviews revealed a predominantly positive reception of the idea of utilizing objective measures for evaluating team performance. However, the experts reported limited experience in actively incorporating objective measures into their training and research. Nevertheless, they identified various potential objective measures, including acoustical, visual, physiological, and endocrinological measures and a time layer. Concerns were raised regarding feasibility, complexity, cost, and privacy issues associated with the use of objective measures. Discussion The study highlights the opportunities and challenges associated with employing objective measures to assess healthcare team performance. It particularly emphasizes the concerns expressed by medical simulation experts and team researchers, providing valuable insights for developers, trainers, researchers, and healthcare professionals involved in the design, planning or utilization of objective measures in team training or research.
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Affiliation(s)
- Rafael Wespi
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Tanja Birrenbach
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefan K. Schauber
- Center for Educational Measurement (CEMO) and Unit for Health Sciences Education, University of Oslo, Oslo, Norway
| | - Tanja Manser
- FHNW School of Applied Psychology, University of Applied Sciences and Arts, Northwestern Switzerland, Olten, Switzerland
- Division of Anesthesiology and Intensive Care, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Huddinge, Sweden
| | - Thomas C. Sauter
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Juliane E. Kämmer
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Social and Communication Psychology, University of Göttingen, Göttingen, Germany
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Baetzner AS, Wespi R, Hill Y, Gyllencreutz L, Sauter TC, Saveman BI, Mohr S, Regal G, Wrzus C, Frenkel MO. Preparing medical first responders for crises: a systematic literature review of disaster training programs and their effectiveness. Scand J Trauma Resusc Emerg Med 2022; 30:76. [PMID: 36566227 PMCID: PMC9789518 DOI: 10.1186/s13049-022-01056-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/30/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Adequate training and preparation of medical first responders (MFRs) are essential for an optimal performance in highly demanding situations like disasters (e.g., mass accidents, natural catastrophes). The training needs to be as effective as possible, because precise and effective behavior of MFRs under stress is central for ensuring patients' survival and recovery. This systematic review offers an overview of scientifically evaluated training methods used to prepare MFRs for disasters. It identifies different effectiveness indicators and provides an additional analysis of how and to what extent the innovative training technologies virtual (VR) and mixed reality (MR) are included in disaster training research. METHODS The systematic review was conducted according to the PRISMA guidelines and focused specifically on (quasi-)experimental studies published between January 2010 and September 2021. The literature search was conducted via Web of Science and PubMed and led to the inclusion of 55 articles. RESULTS The search identified several types of training, including traditional (e.g., lectures, real-life scenario training) and technology-based training (e.g., computer-based learning, educational videos). Most trainings consisted of more than one method. The effectiveness of the trainings was mainly assessed through pre-post comparisons of knowledge tests or self-reported measures although some studies also used behavioral performance measures (e.g., triage accuracy). While all methods demonstrated effectiveness, the literature indicates that technology-based methods often lead to similar or greater training outcomes than traditional trainings. Currently, few studies systematically evaluated immersive VR and MR training. CONCLUSION To determine the success of a training, proper and scientifically sound evaluation is necessary. Of the effectiveness indicators found, performance assessments in simulated scenarios are closest to the target behavior during real disasters. For valid yet inexpensive evaluations, objectively assessible performance measures, such as accuracy, time, and order of actions could be used. However, performance assessments have not been applied often. Furthermore, we found that technology-based training methods represent a promising approach to train many MFRs repeatedly and efficiently. These technologies offer great potential to supplement or partially replace traditional training. Further research is needed on those methods that have been underrepresented, especially serious gaming, immersive VR, and MR.
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Affiliation(s)
- Anke S. Baetzner
- grid.7700.00000 0001 2190 4373Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
| | - Rafael Wespi
- grid.5734.50000 0001 0726 5157Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland ,grid.5734.50000 0001 0726 5157Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Yannick Hill
- grid.12380.380000 0004 1754 9227Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands ,Institute of Brain and Behaviour Amsterdam, Amsterdam, Netherlands ,Lyda Hill Institute for Human Resilience, Colorado Springs, USA
| | - Lina Gyllencreutz
- grid.12650.300000 0001 1034 3451Department of Nursing, Umeå University, Umeå, Sweden ,grid.12650.300000 0001 1034 3451Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Thomas C. Sauter
- grid.5734.50000 0001 0726 5157Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Britt-Inger Saveman
- grid.12650.300000 0001 1034 3451Department of Nursing, Umeå University, Umeå, Sweden ,grid.12650.300000 0001 1034 3451Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Stefan Mohr
- grid.5253.10000 0001 0328 4908Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Georg Regal
- grid.4332.60000 0000 9799 7097Center for Technology Experience, AIT Austrian Institute of Technology, Vienna, Austria
| | - Cornelia Wrzus
- grid.7700.00000 0001 2190 4373Psychological Institute and Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Marie O. Frenkel
- grid.7700.00000 0001 2190 4373Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
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A Region-Wide All-Hazard Training Program for Prehospital Mass Casualty Incident Management: A Real-World Case Study. Disaster Med Public Health Prep 2022; 17:e184. [PMID: 35361292 DOI: 10.1017/dmp.2022.84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We report the development, implementation, and results of a sustainable region-wide mass-casualty management prehospital training program implemented by the Regione Lombardia emergency medical services (EMS) agency AREU in Italy. METHODS The educational program learning objectives are: (1) command and control, communications, and resource management; (2) mass casualty triage and the START triage protocol; (3) on-scene management; (4) Regione Lombardia and AREU Mass Casualty standard operating procedures; and (5) inter-agency communications and relations. For each course edition data on participants' summative assessment, participants' feedback and costs were collected. RESULTS Between June 26, 2013, and December 31, 2020, a total of 84 editions of the provider training event were delivered, training an overall 1329 prehospital providers; 1239 (93%) passed the summative assessment and were qualified as being operationally "ready." Regarding participant feedback, the overall program was rated 4.4 ± 0.7 out of 5. The overall cost of running the provider program during the study period was €321 510 (circa US $382 000). The average cost per edition was €3828 and €242 per participant. CONCLUSIONS We have described a simple yet interactive simulation and blended-learning approach, which has yielded good pass rates, good participant satisfaction, and contained costs to systematically train emergency medical service personnel.
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Butler CR, Webster LB, Diekema DS, Gray MM, Sakata VL, Tonelli MR, Vranas KC. Perspectives of Triage Team Members Participating in Statewide Triage Simulations for Scarce Resource Allocation During the COVID-19 Pandemic in Washington State. JAMA Netw Open 2022; 5:e227639. [PMID: 35435971 PMCID: PMC9016492 DOI: 10.1001/jamanetworkopen.2022.7639] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE The COVID-19 pandemic prompted health care institutions worldwide to develop plans for allocation of scarce resources in crisis capacity settings. These plans frequently rely on rapid deployment of institutional triage teams that would be responsible for prioritizing patients to receive scarce resources; however, little is known about how these teams function or how to support team members participating in this unique task. OBJECTIVE To identify themes illuminating triage team members' perspectives and experiences pertaining to the triage process. DESIGN, SETTING, AND PARTICIPANTS This qualitative study was conducted using inductive thematic analysis of observations of Washington state triage team simulations and semistructured interviews with participants during the COVID-19 pandemic from December 2020 to February 2021. Participants included clinician and ethicist triage team members. Data were analyzed from December 2020 through November 2021. MAIN OUTCOMES AND MEASURES Emergent themes describing the triage process and experience of triage team members. RESULTS Among 41 triage team members (mean [SD] age, 50.3 [11.4] years; 21 [51.2%] women) who participated in 12 simulations and 21 follow-up interviews, there were 5 Asian individuals (12.2%) and 35 White individuals (85.4%); most participants worked in urban hospital settings (32 individuals [78.0%]). Three interrelated themes emerged from qualitative analysis: (1) understanding the broader approach to resource allocation: participants strove to understand operational and ethical foundations of the triage process, which was necessary to appreciate their team's specific role; (2) contending with uncertainty: team members could find it difficult or feel irresponsible making consequential decisions based on limited clinical and contextual patient information, and they grappled with ethically ambiguous features of individual cases and of the triage process as a whole; and (3) transforming mindset: participants struggled to disentangle narrow determinations about patients' likelihood of survival to discharge from implicit biases and other ethically relevant factors, such as quality of life. They cited the team's open deliberative process, as well as practice and personal experience with triage as important in helping to reshape their usual cognitive approach to align with this unique task. CONCLUSIONS AND RELEVANCE This study found that there were challenges in adapting clinical intuition and training to a distinctive role in the process of scarce resource allocation. These findings suggest that clinical experience, education in ethical and operational foundations of triage, and experiential training, such as triage simulations, may help prepare clinicians for this difficult role.
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Affiliation(s)
- Catherine R. Butler
- Division of Nephrology, Department of Medicine, University of Washington, Seattle
- Veterans Affairs Health Services Research and Development Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington
| | - Laura B. Webster
- Bioethics Program, Virginia Mason Medical Center, Seattle, Washington
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle
| | - Douglas S. Diekema
- Department of Pediatrics, University of Washington School of Medicine, Seattle
- Trueman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, Washington
| | - Megan M. Gray
- Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Vicki L. Sakata
- Department of Pediatrics, University of Washington School of Medicine, Seattle
- Northwest Healthcare Response Network, Seattle, Washington
| | - Mark R. Tonelli
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle
| | - Kelly C. Vranas
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland
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Lernen und üben wir das Richtige? Notf Rett Med 2022. [DOI: 10.1007/s10049-020-00824-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ZusammenfassungDer Massenanfall von Verletzten (MANV) ist eine Ausnahmesituation für Rettungsdienst und andere Einsatzkräfte. Trotz niedriger Inzidenz müssen sich die Einsatzkräfte sowohl auf ärztlicher als auch auf nichtärztlicher Seite auf diesen Einsatzfall vorbereiten. In der vorliegenden Pilotstudie wurden anhand einer Fehlermöglichkeits- und -einflussanalyse (FMEA) die kritischen Einsatzfaktoren im MANV ermittelt und mit den Ausbildungscurricula verglichen. Die herangezogenen Curricula waren Notfallsanitäter:in, organisatorische:r Leiter:in, Konzept zur katastrophenmedizinischen Ausbildung im studentischen Unterricht an deutschen Hochschulen, Nationaler Kompetenz-basierter Lernzielkatalog Medizin (NKLM), Zusatz-Weiterbildung Notfallmedizin und Fortbildung zum:zur leitenden Notarzt:ärztin. Die Ergebnisse lassen vermuten, dass in der praktischen Ausbildung der MANV eine eher untergeordnete Rolle spielt. Weitere empirische Untersuchungen sind aus Sicht der Autoren notwendig.
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Tallach R, Schyma B, Robinson M, O'Neill B, Edmonds N, Bird R, Sibley M, Leitch A, Cross S, Green L, Weaver A, McLean N, Cemlyn-Jones R, Menon R, Edwards D, Cole E. Refining mass casualty plans with simulation-based iterative learning. Br J Anaesth 2021; 128:e180-e189. [PMID: 34753594 DOI: 10.1016/j.bja.2021.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Preparatory, written plans for mass casualty incidents are designed to help hospitals deliver an effective response. However, addressing the frequently observed mismatch between planning and delivery of effective responses to mass casualty incidents is a key challenge. We aimed to use simulation-based iterative learning to bridge this gap. METHODS We used Normalisation Process Theory as the framework for iterative learning from mass casualty incident simulations. Five small-scale 'focused response' simulations generated learning points that were fed into two large-scale whole-hospital response simulations. Debrief notes were used to improve the written plans iteratively. Anonymised individual online staff surveys tracked learning. The primary outcome was system safety and latent errors identified from group debriefs. The secondary outcomes were the proportion of completed surveys, confirmation of reporting location, and respective roles for mass casualty incidents. RESULTS Seven simulation exercises involving more than 700 staff and multidisciplinary responses were completed with debriefs. Usual emergency care was not affected by simulations. Each simulation identified latent errors and system safety issues, including overly complex processes, utilisation of space, and the need for clarifying roles. After the second whole hospital simulation, participants were more likely to return completed surveys (odds ratio=2.7; 95% confidence interval [CI], 1.7-4.3). Repeated exercises resulted in respondents being more likely to know where to report (odds ratio=4.3; 95% CI, 2.5-7.3) and their respective roles (odds ratio=3.7; 95% CI, 2.2-6.1) after a simulated mass casualty incident was declared. CONCLUSION Simulation exercises are a useful tool to improve mass casualty incident plans iteratively and continuously through hospital-wide engagement of staff.
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Affiliation(s)
- Rosel Tallach
- Royal London Hospital, London, UK; Raigmore Hospital, Inverness, UK.
| | - Barry Schyma
- Royal London Hospital, London, UK; Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Michael Robinson
- Royal London Hospital, London, UK; Royal Free Hospital, London, UK
| | | | | | | | - Matthew Sibley
- Royal London Hospital, London, UK; University Hospitals Birmingham, Birmingham, UK
| | | | | | | | | | | | | | - Raj Menon
- Royal London Hospital, London, UK; National University Hospital, Singapore
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Preparedness for Mass Casualty Incidents: The Effectiveness of Current Training Model. Disaster Med Public Health Prep 2021; 16:2120-2128. [PMID: 34711298 DOI: 10.1017/dmp.2021.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The importance of MCI organization and training was highlighted by the events of September 11, 2001. Training focuses on the management of physical injuries caused by a single traumatic event over a well-defined, relatively short timeframe. MCI management is integrated into surgical and trauma training, with disaster management training involving the emergency services, law enforcement, and state infrastructure agencies. The COVID-19 pandemic revealed gaps in the preparedness of nation states and global partners in disaster management. The questions that arose include 'has training really prepared us for an actual emergency,' 'what changes need to be made to training to make it more effective,' and 'who else should training be extended to?' This article focuses on the importance of involving multiple sectors in mass casualty training and asks whether greater involvement of non-medical agencies and the public, in operational drills might improve preparedness for global events such as the COVID-19 pandemic.
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Teuben MPJ, Mand C, Moosdorf L, Sprengel K, Shehu A, Pfeifer R, Ruchholtz S, Lefering R, Pape HC, Jensen KO. Simultaneous Casualty Admissions-Do they Affect Treatment in the Receiving Trauma Center? World J Surg 2021; 45:2037-2045. [PMID: 33782732 PMCID: PMC8154817 DOI: 10.1007/s00268-021-06074-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 11/27/2022]
Abstract
Background Simultaneous trauma admissions expose medical professionals to increased workload. The impact of simultaneous trauma admissions on hospital allocation, therapy, and outcome is currently unclear. We hypothesized that multiple admission-scenarios impact the diagnostic pathway and outcome. Methods The TraumaRegister DGU® was utilized. Patients admitted between 2002–2015 with an ISS ≥ 9, treated with ATLS®- algorithms were included. Group ´IND´ included individual admissions, two individuals that were admitted within 60 min of each other were selected for group ´MULT´. Patients admitted within 10 min were considered as simultaneous (´SIM´) admissions. We compared patient and trauma characteristics, treatment, and outcomes between both groups. Results 132,382 admissions were included, and 4,462/3.4% MULTiple admissions were found. The SIM-group contained 1,686/1.3% patients. The overall median injury severity score was 17 and a mean age of 48 years was found. MULT patients were more frequently admitted to level-one trauma centers (68%) than individual trauma admissions were (58%, p < 0.001). Mean time to CT-scanning (24 vs. 26/28 min) was longer in MULT / SIM patients compared to individual admissions. No differences in utilization of damage control principles were seen. Moreover, mortality rates did not differ between the groups (13.1% in regular admissions and 11.4%/10,6% in MULT/SIM patients). Conclusion This study demonstrates that simultaneous treatment of injured patients is rare. Individuals treated in parallel with other patients were more often admitted to level-one trauma centers compared with individual patients. Although diagnostics take longer, treatment principles and mortality are equal in individual admissions and simultaneously admitted patients. More studies are required to optimize health care under these conditions.
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Affiliation(s)
- Michel Paul Johan Teuben
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8090 Zurich, Switzerland
- Department of Surgery, Thurgau Cantonal Hospital, Frauenfeld, Switzerland
| | - Carsten Mand
- Department of Trauma-,Hand-, and Reconstructive Surgery, University Clinic Giessen and Marburg, Marburg, Germany
| | - Laura Moosdorf
- Department of Trauma-,Hand-, and Reconstructive Surgery, University Clinic Giessen and Marburg, Marburg, Germany
| | - Kai Sprengel
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8090 Zurich, Switzerland
| | - Alba Shehu
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8090 Zurich, Switzerland
| | - Roman Pfeifer
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8090 Zurich, Switzerland
| | - Steffen Ruchholtz
- Department of Trauma-,Hand-, and Reconstructive Surgery, University Clinic Giessen and Marburg, Marburg, Germany
| | - Rolf Lefering
- Institute for Research in Operative Medicine (IFOM), University Witten/Herdecke, Cologne, Germany
| | - Hans-Christoph Pape
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8090 Zurich, Switzerland
| | - Kai Oliver Jensen
- Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8090 Zurich, Switzerland
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Lima DS, de-Vasconcelos IF, Queiroz EF, Cunha TA, Dos-Santos VS, Arruda FAEL, Freitas JG. Multiple victims incident simulation: training professionals and university teaching. Rev Col Bras Cir 2019; 46:e20192163. [PMID: 31389523 DOI: 10.1590/0100-6991e-20192163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/07/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to describe the teaching strategy based on the Multiple Victims Incident (MVI) simulation, discussing and evaluating the performance of the students involved in the initial care of trauma victims. METHODS a cross-sectional, and quantitative study was performed. A realistic MVI simulation involving students, and professionals from nursery and medical schools, as well as a prehospital care team was performed. RESULTS it was possible to notice that the classification according to the START method (Simple Triage and Rapid Treatment) was correct in 94.1% of the time from the analysis of 17 preestablished checklists. Following the primary evaluation with the ABCDE mnemonic, all steps were performed correctly in 70%. However, there was only supply of oxygen in high flow in 64.7% of the examination. The search for visible and hidden bleeding was performed in 70.6% of the examination. The neurological evaluation with the Glasgow coma scale and pupillary evaluation occurred in 70.6% of the victims. The victims exposure was performed in 70.6% of the examination. CONCLUSION a simulated environment allows the consolidation and improvement of professional skills, especially when we are talking about a poorly trained area during the undergraduate program, such as the MVI. Early training and teamwork encourage clinical thinking, integration and communication, essential abilities when facing chaotic situations.
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Affiliation(s)
- Daniel Souza Lima
- Universidade de Fortaleza (UNIFOR), Centro de Ciências da Saúde, Curso de Medicina, Fortaleza, CE, Brasil
| | | | - Erika Feitosa Queiroz
- Universidade de Fortaleza (UNIFOR), Centro de Ciências da Saúde, Curso de Enfermagem, Fortaleza, CE, Brasil
| | - Thaís Aguiar Cunha
- Universidade de Fortaleza (UNIFOR), Centro de Ciências da Saúde, Curso de Enfermagem, Fortaleza, CE, Brasil
| | - Vitória Soares Dos-Santos
- Universidade de Fortaleza (UNIFOR), Centro de Ciências da Saúde, Curso de Enfermagem, Fortaleza, CE, Brasil
| | | | - Julyana Gomes Freitas
- Universidade de Fortaleza (UNIFOR), Centro de Ciências da Saúde, Curso de Enfermagem, Fortaleza, CE, Brasil
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