ผลลัพธ์ของการฝึกอบรมการดูแลผู้ป่วยบาดเจ็บก่อนถึงโรงพยาบาลสำหรับผู้ปฏิบัติงานการแพทย์ฉุกเฉิน ในจังหวัดนครสวรรค์

Salin Permkasikam

Authors

Salin Permkasikam Sawanpracharak Hospital

Keywords:

trauma life support, advanced life support, basic life support, emergency medical practitioner

Abstract

Objective : To study the results of a training course on pre-hospital trauma care for emergency medical practitioners in Nakhon Sawan province.

Methods : This study was quasi-experimental. A sample was accident-injured patients, taken care of by the advanced life support (ALS) team and basic life support (BLS) team in Nakhon Sawan province, and taken to Sawanpracharak Hospital. The study compared 2 groups: 1) 105 patients who received the standard care before the teams attended the training, from January 1, 2021 - March 12, 2021, and 2) 105 patients who received care after the teams had the training, from March 13, 2021 - June 30, 2021. Data was collected from the patient record forms to study the suitability of care provided for injured patients from accidents. Statistical comparisons of differences between the two groups were the Student’s t-test or Mann-Whitney test for continuous variables and the Fisher's exact test for group variables, and the level of statistical significance was determined at p-value < 0.05.

Results : Before the training, it was found that the ALS team appropriately provided airway management, hemorrhage control, cervical spine immobilization, appendicular skeleton immobilization, and fluid resuscitation at 100% in all sequences. The BLS team efficiently provided airway management, hemorrhage control, cervical spine immobilization, appendicular skeleton immobilization, and fluid resuscitation at 100, 97.1, 98.8, 95.3, 100 percent, respectively. After the training, the ALS team efficiently gave airway management, hemorrhage control, cervical spine immobilization, appendicular skeleton immobilization, and fluid resuscitation at 100% in all sequences. The BLS team properly provided airway management, hemorrhage control, cervical spine immobilization, appendicular skeleton immobilization, and fluid resuscitation at 100, 97.5, 100, 100, 100 percent, respectively. It was also found that the two groups did not differ in terms of the efficacy of treatments for the injured.

Summary : The suitability of providing pre-hospital care for the injured by emergency medical practitioners in the pre-trained group and the post-trained group in Nakhonsawan Province was not different

Keywords : Pre-hospital trauma life support, Advanced life support team, Basic life support team

References

กองยุทธศาสตร์และแผนงานสำนักงานปลัดกระทรวงสาธารณสุข. สถิติสาธารณสุข พ.ศ.2561. นนทบุรี: กลุ่มข้อมูลข่าวสารสุขภาพ; 2562.

Murad MK, Husum H. Trained lay first responders reduce trauma mortality: a controlled study of rural trauma in Iraq. Prehosp Disaster Med 2010;25:533-9.

Aekka A, Abraham R, Hollis M, Boudiab E, Laput G, Purohit H, et al. Prehospital trauma care education for first responders in India. J Surg Res 2015;197:331-8.

Laput G, Aekka A, Hollis M, Boudiab E, Abraham R, Purohit H, et al. Prehostipal trauma care education for first responders in Rajasthan, India: a multi-institutional study. J Am Coll Surg 2015;221:75.

Johansson J, Blomberg H, Svennblad B, Wernroth L, Melhus H, Byberg L, et al. Prehospital trauma life support (PHTLS) training of ambulance caregivers and impact on survival of trauma victims. Resuscitation 2012;83:1259-64.

Teuben M, Löhr N, Jensen KO, Brüesch M, Müller S, Pfeifer R, et al. Improved pre-hospital care efficiency due to the implementation of pre-hospital trauma life support (PHTLS) algorithms. Eur J Trauma Emerg Surg 2020;46:1321-5.

ศูนย์ข้อมูลและสถิติโรงพยาบาลสวรรค์ประชารักษ์. ข้อมูลสถิติงานอุบัติเหตุฉุกเฉิน โรงพยาบาลสวรรค์ประชารักษ์ จังหวัดนครสวรรค์. นครสวรรค์: โรงพยาบาลสวรรค์ประชารักษ์; 2563.

Mohan SC, Bhatia MB, Martinez CR, Suria N, Helenowski I, Thakur N, et al. Evaluation of a first responders course in rural north India. J Surg Res 2021;268:485-90.

Eisner ZJ, Delaney PG, Thullah AH, Yu AJ, Timbo SB, Koroma S, et al. Evaluation of a lay first responder program in Sierra Leone as a scalable model for prehospital trauma care. Injury 2020;51:2565-73.