Urgentiegeneeskunde bij rampen: mogelijkheden tot verbetering voor artsen in opleiding?

Abstract

Emergency medicine trainees in case of disasters: possibilities for improvement? In Flanders, emergency medicine trainees (EMTs) are first-line responders at mass casualty incidents (MCIs) and must be prepared to manage MCIs. In an inquiry EMTs evaluated their perceived self-confidence, knowledge and skills of MCI management. The hypothesis of the study was that EMTs are not sufficiently prepared to manage MCIs. EMTs of 4 Flemish universities were invited to complete a survey on MCI management. Their knowledge was tested using 7 theoretical questions, and additionally demographic data was collected. The survey was distributed electronically and overseen by emergency physicians qualified in disaster management. The response rate was 35%: 66 trainees completed the survey. Gender and trainee training level was equally distributed. Of the respondents, 32% had followed MCI management courses. Of those, 67% felt they had gained enough knowledge. Only 5% felt their self-confidence was sufficient. Of all trainees, 27% had participated in MCI exercises. The majority of trainees felt MCI exercises were essential to improve self-confidence, knowledge and skills. Trainees rated their self-confidence higher concerning traffic (73%) and house fire MCIs (65%) than regarding biological (20%) or nuclear (15%) MCIs. Those who had followed the two-day MCI course rated their self-confidence higher in understanding general MCI terminology (p < 0.001). Those who had participated in MCI exercises had more confidence in practical skills such as using communication technology (68% vs. 36%, p = 0.013). The EMTs indicated not being prepared enough to manage MCIs. Participation in MCI exercises was associated with higher self-confidence, knowledge and skills. EMTs in Flanders are thus recommended to follow MCI management courses, MCI exercises and e-learning modules before working in the emergency medical service. The universities may take up a coordinating role in the development and organisation of these courses, training exercises and tools.