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Title: Out-of-hospital endotracheal intubation experience, confidence and confidence-associated factors among Northern Japanese emergency life-saving technicians: a population-based cross-sectional study
Authors: Ono, Yuko
Tanigawa, Koichi
Kakamu, Takeyasu
Shinohara, Kazuaki
Iseki, Ken
Affiliation: 救急医療学講座
ふくしま国際医療科学センター
衛生学・予防医学講座
地域救急医療支援講座
Source title: BMJ open
Volume: 8
Issue: 7
Start page: e021858
Issue Date: 13-Jul-2018
Abstract: OBJECTIVE: Clinical procedural experience and confidence are both important when performing complex medical procedures. Since out-of-hospital endotracheal intubation (ETI) is a complex intervention, we sought to clarify clinical ETI experience among prehospital rescuers as well as their confidence in performing ETI and confidence-associated factors. DESIGN: Population-based cross-sectional study conducted from January to September 2017. SETTING: Northern Japan, including eight prefectures. PARTICIPANTS: Emergency life-saving technicians (ELSTs) authorised to perform ETI. OUTCOME MEASURES: Annual ETI exposure and confidence in performing ETI, according to a five-point Likert scale. To determine factors associated with ETI confidence, differences between confident ELSTs (those scoring 4 or 5 on the Likert scale) and non-confident ELSTs were evaluated. RESULTS: Questionnaires were sent to 149 fire departments (FDs); 140 agreed to participate. Among the 2821 ELSTs working at responding FDs, 2620 returned the questionnaire (response rate, 92.9%); complete data sets were available for 2567 ELSTs (complete response rate, 91.0%). Of those 2567 respondents, 95.7% performed two or fewer ETI annually; 46.6% reported lack of confidence in performing ETI. Multivariable logistic regression analysis showed that years of clinical experience (adjusted OR (AOR) 1.09; 95% CI 1.05 to 1.13), annual ETI exposure (AOR 1.79; 95% CI 1.59 to 2.03) and the availability of ETI skill retention programmes including regular simulation training (AOR 1.31; 95% CI 1.02 to 1.68) and operating room training (AOR 1.44; 95% CI 1.14 to 1.83) were independently associated with confidence in performing ETI. CONCLUSIONS: ETI is an uncommon event for most ELSTs, and nearly half of respondents did not have confidence in performing this procedure. Since confidence in ETI was independently associated with availability of regular simulation and operating room training, standardisation of ETI re-education that incorporates such methods may be useful for prehospital rescuers.
Publisher: BMJ Publishing Group
language: eng
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/692
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/692/1/BMJOpen_8_e021858.pdf
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2018-021858
PubMed ID: 30007929
Related Page: https://doi.org/10.1136/bmjopen-2018-021858
Rights: © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Rights: http://creativecommons.org/licenses/by-nc/4.0/
Appears in Collections:a10 学術雑誌論文等 = Journal Article

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