Professional paper
USE OF TRANSPORT VENTILATOR AT THE INSTITUTE OF EMERGENCY MEDICINE OF VARAŽDIN COUNTY
ANĐELA SIMIĆ
orcid.org/0000-0003-0428-1658
; Institute of Emergency Medicine of Varaždin County, Varaždin, Croatia
IVAN JURIĆ
; Sveti Duh University Hospital, Department of Emergency Medicine, Zagreb, Croatia
VIŠNJA NESEK ADAM
orcid.org/0000-0002-6521-4136
; Sveti Duh University Hospital, Department of Emergency Medicine, University Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb and Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia
MARTA LUKAČEVIĆ
; Institute of Emergency Medicine of Varaždin County, Varaždin, Croatia
Abstract
The objective of this study conducted at the Institute of Emergency Medicine of Varaždin County (IEM VC) was to investigate the emergency medicine service (EMS) healthcare workers’ education and capability regarding mechanical ventilation and to explore the use of transport ventilator in daily practice. To quantify EMS healthcare workers’ capability for use of transport ventilator, we developed two clinical scenarios with emphasis on emergency management of ventilated patients, i.e. one during resuscitation (VC CMV mode) and the other for noninvasive mechanical ventilation (SpnCPAP mode). The following data were collected: profession, years of work in the EMS, and year and type of education in the fi eld of mechanical ventilation. Years of work in the EMS were 1-21 years in both scenarios solved, 2 months to 25 years in the fi rst scenario solved, and 1-27 years in neither scenario solved. The number of operating hours of each transport mechanical ventilator
was obtained from the memory of the device at regular service, which is carried out every two years. Out of 21 respondents, 7 (33%) had successfully adjusted the transport mechanical ventilator settings in both scenarios, 6 (29%) only in the scenario of resuscitation, and 8 (38%) failed in both scenarios. Distribution by profession was as follows: 3 out of 8 doctors and 4 out of 13 nurses/technicians successfully solved both scenarios, 3 doctors and 3 nurses/technicians successfully solved first scenario, and 2 doctors and 6 medical nurses/technicians failed to solve both scenarios. Better results were achieved by respondents who had completed the Respiratory and Mechanical Ventilation in Emergency Medicine course or other education in the last two years. Even 19 (90%) respondents expressed the need for additional education. The number of operating hours of transport mechanical ventilator in the last two years was 2 hours and 10 minutes per device. The medical teams of IEM VC often take care of patients who could benefit from the use of transport ventilator because of
their condition. The results suggest that the knowledge about the use of transport mechanical ventilator is not dependent on the years in work in the EMS, being a physician or a nurse/technician. However, this knowledge was found to greatly depend on the type and time of education. Literature data show that even though mechanical ventilation is considered a standard in emergency medicine, the exact time of training required for its use has not been established, and the number of studies investigating the use of mechanical ventilator in the fi ld of emergency medicine is limited. The limitations of this study were a relatively small number of respondents and the fact that each subject was individually tested about working with transport ventilator, whereas teamwork is used in daily work, so that a physician and nurse/ technician together with educated driver provide care of emergency patients. In conclusion, transport ventilator is not used enough in daily care of patients in IEM VC. Much better ability to work with transport ventilator was demonstrated by physicians and nurses/technicians
with a higher level of education in mechanical ventilation, regardless of years of work in the EMS. Considering the large proportion of healthcare workers who have identifi ed the need for additional education, there is a great opportunity to improve the use of mechanical ventilator, with the aim of providing better care for emergency patients.
Keywords
emergency medicine; transport ventilator; education
Hrčak ID:
197878
URI
Publication date:
3.4.2018.
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