緊急救護技術員對小兒緊急救護現況及自信能力之探索性研究

Abstract

本研究旨在探討緊急救護技術員對小兒緊急救護之現況及自信能力。研究採橫斷式調查，運用結構式問卷，以立意取樣方式，選取台北市消防局緊急救護分隊之80名緊急救護技術員為研究對象。研究資料經建檔後，以SPSS 12.0 for windows 套裝軟體進行資料的統計分析。果顯示緊急救護技術員以男性居多(96.3%)，年齡層以31-35歲者最多(41.3%)，學歷以專科居多(93.7%)，平均工作年資為6-10年為多(53.7%)。在特殊證照方面，超過80%緊急救護技術員沒有小兒特殊證照訓練。在救護經驗上， 43.8%緊急救護技術員完全沒有院外死亡案件的處理經驗，28.8%緊急技術員於半年內經歷2次小兒救護案件。所參與救護兒童的年齡層為1-3歲者佔33.8%，且72.5%緊急技術員對於救護1歲以下的小孩較有心理壓力，小兒複訓繼續教育之課室及實習的內容及時數不足。在緊急救護自信能力方面，最有自信的大項為緊急處置技能，其次為急症判斷能力，最後為一般評估能力。綜合細項分析，緊急救護技術員最有自信能力是小兒外傷之處置，感到最無自信能力的部分為小兒靜脈注射技巧。小兒靜脈注射技巧方面，EMT-2信心得分明顯大於EMT-P，小兒心肺復甦術之技巧EMT-P信心得分明顯大於EMT-2。複訓課室上課與臨床實習內容及時間、師資滿意度與自信能力有顯著相關。研究顯示緊急救護訓練課程及實習內容需做加強與調整，讓緊急救護技術員在小兒的救護方面可以有充足的自信及能力來應付小兒救護的壓力，進而提昇小兒救護的品質，讓小兒的生命價值更有保障。

This study is to explore the condition and confidence in pediatric resuscitation for emergency medical technicians. A cross-sectional, descriptive and correlation design was conducted. Eighty emergency medical technicians (EMTs) were selected from Taipei Fire Department Emergency Medical Services Division by a purposively sampling. Data were analyzed with SPSS 12.0 for windows.he study results showed that most of EMTs were male (96.3%), aged 31 to 35 years old (41.3%), graduated from the Police College School (93.7%). The average of emergency medical care experience was between 6 to10 years (53.7%). More than 80% EMTs did not take Pediatric Advanced Life Support (PALS) and Advanced Pediatric Life Support (APLS) training. Most EMTs didn’t have the experience of pediatric out-hospital cardiac arrest. Most cases of pediatrics on EMS call were age between 1 to 3 years old. EMTs had psychological pressure on caring the patient under 1 year old. The average pediatric case numbers in each EMT were 2 cases per half year. Most of EMTs responded the lack of adequate content and sufficient times in pediatric continuing education and clinical training. The most confidence level of pediatric emergency care reported by EMTs is emergent management, critical judgment and general assessment in order. Analysis of study items, EMTs showed most confidence in the management of pediatric trauma but weakness in the skill of implanted peripheral intravenous catheter. EMT-2 had more confidence on the skills of intravenous catheter implantation but EMT-P had more confidence on the skill of pediatric cardiopulmonary resuscitation. Continue post-graduate training, content and duration of training program and satisfaction of faculty affect confidence in pediatric resuscitation significantly.The findings of the study suggested strengthening the post-graduate pediatric training program and content of clinical training for EMTs. The study hopes to enhance confidence and competence of EMT in pediatric EMS care, and improve the quality of pediatric emergency care and the life of pediatric patients.