National consensus on communication in prehospital trauma care, the DENIM study.

Autor: Harmsen AMK; Department of Surgery, VU University Medical Centre Amsterdam, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands. a.harmsen@vumc.nl., Geeraedts LMG Jr; Department of Surgery, VU University Medical Centre Amsterdam, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands., Giannakopoulos GF; Department of Surgery, VU University Medical Centre Amsterdam, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands., Terra M; Department of Surgery, VU University Medical Centre Amsterdam, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands., Christiaans HMT; Department of Anaesthesiology VU University Medical Centre Amsterdam, Amsterdam, the Netherlands., Mokkink LB; Department of Epidemiology and Biostatistics, and EMGO Institute for Health and Care Research, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands., Bloemers FW; Department of Surgery, VU University Medical Centre Amsterdam, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2017 Jul 11; Vol. 25 (1), pp. 67. Date of Electronic Publication: 2017 Jul 11.
DOI: 10.1186/s13049-017-0414-9
Abstrakt: Background: In the Netherlands prehospital trauma care is provided by emergency medical services (EMS) nurses. This care is extended by Physician staffed Helicopter Emergency Medical Services (P-HEMS) for the more severely injured patient. Prehospital communication is a factor of influence on the identification of these patients and the dispatch of P-HEMS. Though prehospital communication it is often perceived to be incomplete and unstructured. To elucidated factors of influence on prehospital triage and the identification of the severely injured patient a Delphi study was performed.
Methods: A three round modified Delphi study was designed to explore concepts amongst experts in prehospital trauma care. P-HEMS physicians/nurses, trauma surgeons, EMS nurses and dispatch center operators where asked to state their opinion regarding identification of the poly trauma patient, trauma patient characteristics, prehospital communication and prehospital handover.
Results: Seventy-one panellist completed all three rounds. For the first round seven cases and 13 theses were presented. From the answers/argumentation the second round was build, in which 68 theses had to be ranked within four principle themes: factors that influence prehospital communication, critical information for proper handover, factors influencing collaboration and how training/education can influence this. Out of these answers the third survey was build, focussing on determining the exact content of a prehospital trauma handover. The majority of the panellists agreed to a set of parameters resulting in a new model of inter-professional hand over regarding prehospital trauma patients.
Discussion: Exact identification of the poly trauma patient in need of care by P-HEMS is difficult though prehospital communication and the prehospital handover may be improved.
Conclusion: The respondents report that prehospital communication needs to be unambiguous to improve trauma care. Consensus was reached on a set of ten parameters that should minimally be handed over with regard to a prehospital trauma patient. This to facilitate prehospital communication between the Dispatch centre, EMS, P-HEMS and the receiving hospital.
Databáze: MEDLINE
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