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首页> 外文期刊>Prehospital emergency care >Resident field response in an emergency medicine prehospital care rotation.
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Resident field response in an emergency medicine prehospital care rotation.

机译：住院前急诊轮换中的居民现场响应。

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BACKGROUND: Emergency medical services (EMS) is an important component of emergency medicine residency curricula. For over 20 years, residents at a university-affiliated program have staffed a physician response vehicle and responded to selected calls in an urban EMS system with online faculty backup. OBJECTIVES: To describe the prehospital educational experience and patient care provided through this unique program and to assess residents' perceptions. METHODS: This was a three-year retrospective study of patient care records for all prehospital resident responses. Information obtained included complaint, disposition, procedures performed, and medications administered. The number of EMS radio consultations provided by residents during this rotation was also sought. We surveyed 43 current and recently graduated residents to assess their perceptions of this experience. RESULTS: Residents treated 1,434 patients during 1,381 scene responses (16.7 field patient contacts per resident-year). Complaints included cardiac arrest (788, 55.0%) and neurologic (230, 16.0%), traumatic (194, 13.5%), respiratory (144, 10.0%), and other cardiac (40, 2.8%) emergencies. Most patients (1,022; 71.3%) were transported to the hospital, including 82 of 143 patients (57.3%) who initially refused EMS transport. Residents performed procedures on 546 responses (39.5%), including 123 successful intubations, 115 central lines, 43 peripheral (IV) lines, and 10 intraosseous lines. EMS radio consultation records were available for only the second half of the study period. Residents provided 11,583 consultations during this one-and-a-half-year period (264 radio consultations per resident-year). Of the 40 returned surveys (93.0%), autonomy (n = 21), medical decision making (n = 10), and management of high-acuity patients (n = 7) were the most important perceived benefits of this program. CONCLUSION: Our prehospital training program incorporates emergency medicine residents as in-field physicians and allows hands-on opportunity to provide patient care for a variety of conditions in the EMS environment, as well as extensive experience in online medical direction. The trainees believed it had a strong positive impact on their acquisition of important emergency medicine abilities.
机译：背景：紧急医疗服务（EMS）是紧急医疗驻地课程的重要组成部分。 20多年来，大学附属计划的居民配备了医生响应工具，并使用在线教师备份响应了城市EMS系统中选定的呼叫。目的：描述通过该独特计划提供的院前教育经验和患者护理，并评估居民的看法。方法：这是一项对所有院前住院病人反应的患者护理记录的三年回顾性研究。获得的信息包括投诉，处置，执行的程序以及所用药物。还要求轮换期间居民提供的EMS无线电咨询次数。我们调查了43位当前和即将毕业的居民，以评估他们对该经历的看法。结果：居民在1,381例现场反应中治疗了1,434例患者（每居民年16.7位现场患者接触）。投诉包括心脏骤停（788，55.0％）和神经系统（230，16.0％），外伤性（194，13.5％），呼吸道（144，10.0％）和其他心脏紧急情况（40，2.8％）。大多数患者（1,022; 71.3％）被送往医院，其中143位患者中有82位最初拒绝了EMS运送（57.3％）。居民对546例反应（39.5％）进行了手术，包括123例成功插管，115例中心线，43例外围（IV）线和10例骨内线。 EMS无线电咨询记录仅在研究期的下半年可用。一年半的时间里，居民提供了11,583次咨询（每居民年264次无线电咨询）。在40项返回的调查中（93.0％），自主性（n = 21），医疗决策（n = 10）和高敏患者的管理（n = 7）是该计划最重要的感知收益。结论：我们的院前培训计划吸收了急诊医学住院医师作为现场医生，并提供了动手实践的机会，为EMS环境中的各种情况提供患者护理，以及在线医学指导方面的丰富经验。学员们认为，这对他们获得重要的急诊医学能力有很大的积极影响。

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