评估旁观者急救：急救质量评估 (FAQA) 工具的开发和验证,BMC Emergency Medicine

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评估旁观者急救：急救质量评估 (FAQA) 工具的开发和验证
BMC Emergency Medicine ( IF 2.3 ) Pub Date : 2023-04-04 , DOI: 10.1186/s12873-023-00811-z
Siri Idland _{1,

2} , Jo Kramer-Johansen _{2,

3} , Håkon Kvåle Bakke _{4,

5} , Magnus Hjortdahl _{1,

2}

Affiliation

伤害是全世界死亡的主要原因之一。现场的旁观者可以在卫生服务人员到达之前进行急救措施。急救措施的质量可能会影响患者的预后。然而，关于其对患者结果影响的科学证据是有限的。为了正确评估旁观者急救质量、衡量效果并促进改进，需要经过验证的评估工具。本研究的目的是开发和验证急救质量评估 (FAQA) 工具。FAQA 工具侧重于根据到达现场的救护人员评估的 ABC 原则对受伤患者采取的急救措施。在第 1 阶段，我们起草了 FAQA 工具的初始版本，用于评估气道管理、控制外出血、恢复体位和预防体温过低。一组救护人员协助介绍了该工具并对其进行了措辞。在第 2 阶段，我们制作了八部虚拟现实 (VR) 影片，每部影片都呈现了旁观者进行急救的受伤场景。在第 3 阶段，专家组讨论了 FAQA 工具应如何对每个场景进行评级，直至达成共识。随后，19 名受访者（全部是救护人员）使用 FAQA 工具对这八部电影进行了评分。我们通过目视检查和 Kendall 的一致性系数评估了同时有效性和评估者间的一致性。专家组的 FAQA 评分与受访者对所有八部电影的所有急救措施的中位数的 ± 1 一致，除了一个案例，其中出现了 2 的偏差。评分者之间的一致性对于三项急救措施“非常好”，一项“好”，对于急救措施的整体质量评分“中等”。

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Assessing bystander first aid: development and validation of a First Aid Quality Assessment (FAQA) tool

Injuries are one of the leading causes of death worldwide. Bystanders at the scene can perform first aid measures before the arrival of health services. The quality of first aid measures likely affects patient outcome. However, scientific evidence on its effect on patient outcome is limited. To properly assess bystander first aid quality, measure effect, and facilitate improvement, validated assessment tools are needed. The purpose of this study was to develop and validate a First Aid Quality Assessment (FAQA) tool. The FAQA tool focuses on first aid measures for injured patients based on the ABC-principle, as assessed by ambulance personnel arriving on scene. In phase 1, we drafted an initial version of the FAQA tool for assessment of airway management, control of external bleeding, recovery position and hypothermia prevention. A group of ambulance personnel aided presentation and wording of the tool. In phase 2 we made eight virtual reality (VR) films, each presenting an injury scenario where bystander performed first aid. In phase 3, an expert group discussed until consensus on how the FAQA tool should rate each scenario. Followingly, 19 respondents, all ambulance personnel, rated the eight films with the FAQA tool. We assessed concurrent validity and inter-rater agreement by visual inspection and Kendall’s coefficient of concordance. FAQA-scores by the expert group concurred with ± 1 of the median of the respondents on all first aid measures for all eight films except one case, where a deviation of 2 was seen. The inter-rater agreement was “very good” for three first aid measures, “good” for one, and “moderate” for the scoring of overall quality on first aid measures. Our findings show that it is feasible and acceptable for ambulance personnel to collect information on bystander first aid with the FAQA tool and will be of importance for future research on bystander first aid for injured patients.

更新日期：2023-04-04

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