Comparison of manual statements from out-of-hospital trauma training programs and a national guideline on treatment of patients with severe and multiple injuries.
Education
Evidence-based
Prehospital
Treatment
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
06
03
2021
accepted:
09
08
2021
pubmed:
25
8
2021
medline:
18
6
2022
entrez:
24
8
2021
Statut:
ppublish
Résumé
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. 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 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. 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.
Identifiants
pubmed: 34426883
doi: 10.1007/s00068-021-01768-z
pii: 10.1007/s00068-021-01768-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2207-2217Informations de copyright
© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.
Références
ITLS. The ITLS Approach. 2020. https://www.itrauma.org/education/itls-approach/ . Accessed on 11 Jul 2020.
NAEMT. PHTLS textbook. 9th ed. Burlington: Jones & Bartlett Learning; 2018.
Office for the inter-agency Quality assurance in emergency medical services Baden-Württemberg. Quality Report 2019. https://www.sqrbw.de/adbimage/1735/asset-original//sqrbw_qualitaetsbericht-2019.pdf . Accessed on 25 Jul 2020.
Bouillon B, Pieper D, Flohé S, Eikermann M, Prengel P, Ruchholtz S, et al. Level 3 guideline on the treatment of patients with severe/multiple injuries: AWMF Register-Nr. 012/019. Eur J Trauma Emerg Surg. 2018. https://doi.org/10.1007/s00068-018-0922-y .
doi: 10.1007/s00068-018-0922-y
pubmed: 29623341
AWMF. AWMF-Regelwerk Leitlinien: Stufenklassifikation nach Systematik. https://www.awmf.org/leitlinien/awmf-regelwerk/ll-entwicklung/awmf-regelwerk-01-planung-und-organisation/po-stufenklassifikation.html . Accessed on 23 Jun 2021.
Centre for Evidence-Based Medicine. OCEBM Levels of Evidence. 2011. http://www.cebm.net/index.aspx?o=5653 . Accessed on 10 Jun 2015.
The ATLS Subcommittee, American College of Surgeons’Committee on Trauma, and the International ATLS working group. Advanced trauma life support (ATLS
Knacke PG, Rossi R, Rupp P, Schnelle R, Seekamp A, editors. Das Trauma-Buch: Präklinische Versorgung Verletzter. 13th ed. Edewecht: Verlagsgesellschaft Stumpf + Kossendey mbH, Edewecht; 2018.
Münzberg M, Mutschler M, Paffrath T, Trentzsch H, Wafaisade A, Walcher F, et al. Level of evidence analysis for the latest german national guideline on treatment of patients with severe and multiple injuries and ATLS. World J Surg. 2015;39:2061–7. https://doi.org/10.1007/s00268-015-3063-z .
doi: 10.1007/s00268-015-3063-z
pubmed: 25894400
Häske D, Stuke L, Bernhard M, Heller AR, Schweigkofler U, Gliwitzky B, Münzberg M. Comparison of the Prehospital Trauma Life Support recommendations and the German national guideline on treatment of patients with severe and multiple injuries. J Trauma Acute Care Surg. 2016;81:388–93. https://doi.org/10.1097/TA.0000000000001125 .
doi: 10.1097/TA.0000000000001125
pubmed: 27257703
McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22:276–82.
doi: 10.11613/BM.2012.031
Davis DP, Koprowicz KM, Newgard CD, Daya M, Bulger EM, Stiell I, et al. The relationship between out-of-hospital airway management and outcome among trauma patients with Glasgow Coma Scale Scores of 8 or less. Prehosp Emerg Care. 2011;15:184–92. https://doi.org/10.3109/10903127.2010.545473 .
doi: 10.3109/10903127.2010.545473
pubmed: 21309705
pmcid: 4091894
Eckstein M, Chan L, Schneir A, Palmer R. Effect of prehospital advanced life support on outcomes of major trauma patients. J Trauma. 2000;48:643–8. https://doi.org/10.1097/00005373-200004000-00010 .
doi: 10.1097/00005373-200004000-00010
pubmed: 10780596
Lockey DJ, Healey B, Crewdson K, Chalk G, Weaver AE, Davies GE. Advanced airway management is necessary in prehospital trauma patients. Br J Anaesth. 2015;114:657–62. https://doi.org/10.1093/bja/aeu412 .
doi: 10.1093/bja/aeu412
pubmed: 25540067
Davis DP, Hoyt DB, Ochs M, Fortlage D, Holbrook T, Marshall LK, Rosen P. The effect of paramedic rapid sequence intubation on outcome in patients with severe traumatic brain injury. J Trauma. 2003;54:444–53. https://doi.org/10.1097/01.TA.0000053396.02126.CD .
doi: 10.1097/01.TA.0000053396.02126.CD
pubmed: 12634522
Bernard SA, Nguyen V, Cameron P, Masci K, Fitzgerald M, Cooper DJ, et al. Prehospital rapid sequence intubation improves functional outcome for patients with severe traumatic brain injury: a randomized controlled trial. Ann Surg. 2010;252:959–65. https://doi.org/10.1097/SLA.0b013e3181efc15f .
doi: 10.1097/SLA.0b013e3181efc15f
pubmed: 21107105
Wetsch WA, Hinkelbein J. Current national recommendations on rapid sequence induction in Europe How standardised is the ‘standard of care’? Eur J Anaesthesiol. 2014. https://doi.org/10.1097/EJA.0000000000000076 .
doi: 10.1097/EJA.0000000000000076
pubmed: 24827967
van den Heuvel I, Wurmb TE, Böttiger BW, Bernhard M. Pros and cons of etomidate–more discussion than evidence? Curr Opin Anaesthesiol. 2013;26:404–8. https://doi.org/10.1097/ACO.0b013e328362a84c .
doi: 10.1097/ACO.0b013e328362a84c
pubmed: 23743556
Prause G, Orlob S, Auinger D, Eichinger M, Zoidl P, Rief M, Zajic P. System und Fertigkeitseinsatz in einem österreichischen Notarztsystem: retrospektive Studie. [System and skill utilization in an Austrian emergency physician system: retrospective study]. Anaesthesist. 2020. https://doi.org/10.1007/s00101-020-00820-8 .
doi: 10.1007/s00101-020-00820-8
pubmed: 32696083
pmcid: 7544713
Kleber C, Giesecke MT, Tsokos M, Haas NP, Buschmann CT. Trauma-related preventable deaths in Berlin 2010: need to change prehospital management strategies and trauma management education. World J Surg. 2013;37:1154–61. https://doi.org/10.1007/s00268-013-1964-2 .
doi: 10.1007/s00268-013-1964-2
pubmed: 23430005
Kleber C, Giesecke MT, Lindner T, Haas NP, Buschmann CT. Requirement for a structured algorithm in cardiac arrest following major trauma: epidemiology, management errors, and preventability of traumatic deaths in Berlin. Resuscitation. 2014;85:405–10. https://doi.org/10.1016/j.resuscitation.2013.11.009 .
doi: 10.1016/j.resuscitation.2013.11.009
pubmed: 24287328
Advanced trauma life support. Student course manual. Chicago, IL: American College of Surgeons; 2018.
Frank CB, Wölfl CG, Hogan A, Suda AJ, Gühring T, Gliwitzky B, Münzberg M. PHTLS
doi: 10.1186/1752-2897-8-7
pubmed: 25050135
pmcid: 4104731
Deutsche Gesellschaft für Unfallchirurgie. Informationen zum Zertifizierungsverfahren TraumaNetzwerk DGU. http://www.traumanetzwerk-dgu.de/fileadmin/user_upload/traumanetzwerk-dgu.de/docs/Kundeninfo_TNW_April_2016_komprimiert.pdf . Accessed 27 June 2020.