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Simulation training for emergency teams to manage acute ischemic stroke by telemedicine

机译：应急团队通过远程医疗管理急性缺血性中风的模拟培训

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Telemedicine contributes to initiating early intravenous recombinant tissue plasminogen activator (rt-PA) treatment for patients with acute cerebral infarction in areas without a stroke unit. However, the experience and skills of the emergency teams in the spokes to prepare patients and administer rt-PA treatment are ill-defined. Improving these skills could vastly improve management of acute stroke by telemedicine. We developed a medical simulation training model for emergency teams to perform intravenous rt-PA treatment in a telestroke system.From February 2013 to May 2015, 225 learners from 6 emergency teams included in the telestroke system “Virtuall”—in Lorrain (northeastern France)—received a standardized medical simulation training module to perform rt-PA treatment. All learners were assessed with the same pretraining and posttraining test consisting of 52 items. The percentage of right answers was determined for every learner before and after training.Median percentages of right answers were significantly higher in the posttraining test overall (82 ± 10 vs. 59 ± 13% pretraining; P < 0.001), but also in all professional subgroups: physicians (88 ± 8 vs. 67 ± 12%; P < 0.001), paramedical staff (80 ± 9 vs. 54 ± 12%; P < 0.001), nurses (80 ± 8 vs. 54 ± 12%; P < 0.001), and auxiliary nurses (76 ± 17 vs. 37 ± 15%; P = 0.002).We describe for the first time a training model for emergency teams in a telestroke system. We demonstrate significant gain in knowledge for all groups of healthcare professionals. This simulation model could be applied in any medical simulation center and form the basis of a standardized training program of spokes in a telestroke system.
机译：远程医疗有助于在没有中风病的地区对患有急性脑梗死的患者启动早期静脉内重组组织纤溶酶原激活剂（rt-PA）治疗。但是，应急团队在辐照准备患者和进行rt-PA治疗方面的经验和技能尚不清楚。改善这些技能可以极大地改善远程医疗对急性中风的管理。我们为急诊小组开发了一种医疗模拟训练模型，以在远程脑卒中系统中进行rt-PA静脉内治疗。从2013年2月到2015年5月，位于洛林（法国东北部）的远程卒中系统“ Virtuall”中的6个急诊小组的225名学习者-接收了执行rt-PA治疗的标准化医学模拟培训模块。所有学习者均接受由52个项目组成的相同的培训前和培训后测试。在培训前后确定每个学习者的正确答案百分比。在训练后的总体测试中，正确答案的中位数百分比显着更高（培训前为82±10比59±13％; P <0.001），但在所有专业中亚组：医师（88％±8％vs 67％±12％; P <0.001），医务人员（80％±9％vs.54％±12％; P <0.001），护士（80％±8％vs.54％±12％; P <0.001）和辅助护士（76±17 vs. 37±％15％; P = 0.002）。我们首次描述了在远程中风系统中应急小组的训练模型。我们证明了所有专业医疗保健人员所获得的大量知识。该仿真模型可以在任何医疗仿真中心中使用，并构成了远程行程系统中辐条标准化培训计划的基础。

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