Advanced Trauma Life Support Provider Course in Taiwan

高級外傷救命術在台灣推行狀況

陳石池(Shyr-Chyr Chen) ； 蔡明哲(Ming-Che Tsai) ； 劉曉東(Hsiao-Dung Liu) ； 陳瑞杰(Ray-Jade Chen) ； 方禎峰(Jen-Feng Fang) ； 柯敦仁(Tun-Jen Ko) ； 黃睦舜(Mu-Shun Huang) ； 楊大羽(Dar-Yu Yang) ； 林芳郁(Fang-Yue Lin) ； 李建賢(Chen-Hsen Lee)

《中華民國急救加護醫學會雜誌》 12卷3期 (2001/09) Pp. 111-118

https://doi.org/10.30018/JECCM.200109.0003

摘要

背景：台灣在1996年引進高級外傷救命術，我們評估高級外傷救命術在提供醫師們對受傷病人的急救知識和技巧的效果。
方法：216位醫師在接受高級外傷救命術訓練後填寫問卷，問卷設計允許參加著描述他們的觀點和評論，對醫師臨床上的幫助分為2至4種不同的程度，然後對問卷做統計分析。
結果：本研究共有210位男性6位女性，年齡從25隧道58歲(平均31歲)，上課、技術演練、動物實驗、檢傷分類和初步評估對醫師的幫助分別為39%，62%，37%，52%和63%。最有用的課程為休克(69%)，初步評估處理(67%)和呼吸換氣處理(52%)。技術演練最有幫助的是脊椎傷害(61%)，休克評估處理(57%)和胸部X光判讀。75%的醫師認為高級外傷救命術對他們幫助非常大，但祇有30%的醫師認為高級外傷救命術適合在台灣推廣，47%的醫師認為高級外傷救命術修改後，才適合在台灣推廣。
結論：高級外傷救命術對醫師們的幫助在本研究中得到確認，但不同的訓練內容對醫師們的幫助各有不同。我們認為保留高級外傷救命術的基本急救課程，然後增加不同國家的外傷流行病學資料，才適合推廣到不同國家。

關鍵字

高級外傷救命術 ； 外傷 ； 急救

並列摘要

Background: Advanced Trauma Life Support (ATLS) was introduced into Taiwan in 1996. We evaluated the effectiveness of the ATLS provider course in providing physicians with trauma knowledge and resuscitation skills in the care of the injured patient.
Materials and Methods: Two hundred sixteen physicians who received ATLS training were prospectively included in this study. A questionnaire was designed to allow the participants to describe their points of view and comments about the entire training program. The degree of helpfulness to the physician’s personal practice was graded on a scale of two to four degrees. Every participant was requested to complete the questionnaire at the end of the ATLS course. All questionnaires were collected for analysis.
Results: There were 210 men and 6 women in this study. Their ages ranged from 25 to 58 years (mean 31 years). Lectures, practical skills, animal experiment sessions (surgical skills), triage scenarios, and initial assessment practices were helpful for 39%, 62%, 37%, 52%, and 63% of physicians, respectively. Shock (69%), initial assessment and management (67%) and airway and ventilatory management (52%) were the three most helpful lectures. X-ray identification of thoracic injuries (55%) were the three most helpful skills. Most physicians (75%) confirmed that the ATLS course helped them very much in their practice. However, only 30% of physicians considered the ATLS course suitable for training physicians in Taiwan and 47% of physicians suggested that part of the ALTS contents should be revised when used to teach physicians in Taiwan.
Conclusions: ATLS training does help in physicians’ practice, as confirmed in this study. However, the different teaching programs had different impacts on the physicians’ practice. We suggest preserving the core concept of trauma resuscitation and modifying the ATLS course when teaching surgeons and non-surgeons. We also suggest that trauma reports from the host country be used when the course is taught in contries other than the United States.

並列關鍵字

advanced trauma life support ； trauma resuscitation