Abstract
BackgroundPrehospital 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.MethodsThis 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.ResultsWe 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.ConclusionThe 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 registrationGerman Clinical Trials Register, ID DRKS00004713, registered 14. February 2014
Highlights
Prehospital trauma care is stressful and requires multi-professional teamwork
Lower incidence of severely injured trauma patients, decreased routine and considerable stress on health care providers underline the importance of effective training in emergency medicine [6]
At the instigation of the medical director, Pre-Hospital Trauma Life Support (PHTLS) courses were mandatorily established for all paramedics in the Emergency Medical Service (EMS) Wiesbaden [8]. Goals of this investigation Under the circumstances that a large EMS- district introduces this standard training, the goal of this study is to investigate the subjective safety in prehospital trauma care and learning progress by paramedics in a longitudinal analysis
Summary
Prehospital trauma care is stressful and requires multi-professional teamwork. A decrease in the number of accident victims 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. Emergency care professionals are faced with stressful and complex situations in prehospital care of seriously injured patients [1,2,3]. In medical simulation training, it was demonstrated - by means of salivary alpha-amylase analysis - that training caused similar stress to real clinical situations. Lower incidence of severely injured trauma patients, decreased routine and considerable stress on health care providers underline the importance of effective training in emergency medicine [6]
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