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[Assessment of primary care paediatricians performance in a paediatric trauma simulation]
E Civantos Fuentes1, A Rodríguez Núñez, J A Iglesias Vázquez
1Centro de Salud de Barranco Grande, Santa Cruz de Tenerife, España. ecivantos@terra.es
Insights
Pediatricians struggle with the primary ABCDE trauma care sequence and cervical spine precautions during simulation training. Educational programs need enhancement to improve initial trauma management skills for better patient safety.
Area of Science:
- Medical Education
- Pediatric Emergency Medicine
- Simulation Training
Context:
- Advanced simulation training can enhance pediatric trauma patient management.
- Effective initial management is critical for improving outcomes in injured children.
- Simulation-based education is a key tool for improving pediatric critical care skills.
Purpose:
- To evaluate the performance of primary care pediatricians in managing pediatric trauma patients using a simulation scenario.
- To identify specific areas of weakness in the initial trauma care approach among pediatric providers.
- To assess the effectiveness of current simulation training in addressing critical trauma management skills.
Summary:
- A retrospective analysis of 156 pediatric primary care providers in 39 teams was conducted using a national simulation training program.
- While basic interventions like pulse oximetry and oxygen were universally applied, critical steps like the primary survey (ABCDE) and cervical spine immobilization were frequently performed incorrectly.
- The average team score on a 16-point scale was 5.3 ±1.8, indicating significant deficiencies in trauma management protocols.
Impact:
- Findings highlight a gap in pediatricians' ability to apply the primary ABCDE trauma care sequence and cervical spine precautions.
- Results underscore the need for improved educational programs focusing on practical, critical checkpoints in initial trauma management.
- Enhancing simulation training can lead to reduced errors and improved patient safety in pediatric trauma care.
Introduction:
Training by means of advanced simulation can improve the paediatrician's abilities in the management of paediatric trauma patients, as well as decreasing errors and increasing patient safety. The initial management is an essential factor in the outcome of an injured child.
Material And Methods:
A trauma patient scenario was included in a national simulation training program. The performances of 156 paediatric primary care providers, divided into 39 teams, who participated in the courses carried out from May 2008 until February 2010 were retrospectively analysed. The evaluation of the scenario was based both on the primary survey suggested by the Working Group on Trauma of the SECIP, and in the 8 main targets of a simulation evaluation tool from the Cincinnati Children's Hospital trauma care program.
Results:
A pulse oximeter was placed, the intravenous/intraosseous access was indicated, the blood pressure was checked, and the oxygen was applied In 100% of the scenarios. An intravenous fluid bolus was indicated in 87% of the scenarios. The Glasgow scale was performed in 5.1%, and the appropriate warming measures in 25.6%. The bilateral cervical immobilisation was incorrect in 35% of the scenarios (89.7%). The primary survey (ABCDE) was checked correctly in only one scenario. With a top score of 16, based on Cincinnati Hospital, the teams mean score was 5.3 ±1.8.
Conclusions:
Primary care paediatricians have problems applying the primary ABCDE trauma care sequence and the cervical spine precautions in a trauma simulation scenario. Educational programs for paediatricians must improve the practical check points of the initial approach to trauma management.
