Preverjanje znanja primarne triaže pri zdravstvenih delavcih v nujni medicinski pomoči in poklicnih gasilcih : diplomsko delo

Slak, Žiga (avtor), Thaler, Darja (mentor), Metelko, Žiga (komentor), Dolenc, Eva (recenzent)

Uvod: Množične nesreče predstavljajo velik izziv za zdravstveni sistem in službe zaščite in reševanja, saj v kratkem času pride do velikega števila poškodovanih oseb, ki jih je treba hitro oceniti in ustrezno razvrstiti glede na nujnost oskrbe. Ključni postopek v takšnih razmerah je primarna triaža, ki mora biti izvedena hitro, natančno in usklajeno. V Sloveniji se pri tem najpogosteje uporablja triažni algoritem SIEVE, ki omogoča hitro ter strukturirano razvrščanje poškodovancev glede na resnost njihovega stanja. Ker so poklicni gasilci pogosto med prvimi na kraju dogodka, imajo ključno vlogo pri začetni oceni situacije in razvrščanju poškodovanih. V okoliščinah, kjer je čas odločilen dejavnik, njihovo hitro in usklajeno delovanje pomembno vpliva na nadaljnji potek intervencije. Sodelovanje med intervencijskimi službami, zlasti med ekipami NMP-ja in gasilci, je bistveno za zagotavljanje učinkovite in varne obravnave poškodovanih v razmerah množične nesreče. Namen: Namen diplomskega dela je ugotoviti nivo znanja o izvajanju primarne triaže v primeru množične nesreče med zdravstvenimi delavci zaposlenimi v NMP in poklicnimi gasilci. Metode dela: V raziskavi smo uporabili deskriptivno metodo dela in kvantitativni pristop s presečno raziskavo. Podatke smo pridobili s strukturiranim anketnim vprašalnikom, ki je vseboval 20 simuliranih primerov poškodovancev, pri katerih so anketiranci morali določiti triažno kategorijo in ustrezne zdravstvene postopke po algoritmu SIEVE. Zbiranje podatkov je potekalo prek spletne platforme 1KA, podatke pa smo analizirali s programoma Excel in SPSS. Za preverjanje razlik med skupinama smo uporabili T-test in Mann-Whitney U test, statistična značilnost pa je bila določena pri p < 0,05. Rezultati: V raziskavi, kjer je sodelovalo 104 anketirancev (57 gasilcev in 47 zdravstvenih delavcev v NMP), so poklicni gasilci dosegli statistično značilno boljše rezultate pri določanju triažnih kategorij po algoritmu SIEVE (92 %) kot zdravstveni delavci (84 %, p < 0,001). Pri izbiri ustreznih zdravstvenih postopkov so bili rezultati podobni (gasilci v 64,5 %, zdravstveni delavci v 60 %), vendar razlika ni bila statistično značilna. Najpogostejša napaka vseh anketirancev je bila izbira ukrepov, ki ne sodijo v okvir primarne triaže. Večina vseh anketirancev (92 %) meni, da bi bilo za izboljšanje pripravljenosti potrebno izvajati več praktičnih vaj. Razprava in zaključek: Na podlagi izvedene raziskave in primerjave s strokovnimi članki iz tujine smo ugotovili, da lahko ustrezno usposobljeni poklicni gasilci uspešno izvajajo primarno triažo po algoritmu SIEVE. Tudi drugi avtorji so ugotovili, da lahko ne-medicinsko osebje ob ustreznem usposabljanju zelo učinkovito izvaja triažo, kar potrjuje pomembnost izobraževanja in simulacij. Naše ugotovitve kažejo tudi na pogoste napačne izbire postopkov, ki ne sodijo v primarno triažo. Ugotovili smo, da je redno utrjevanje znanja bistvenega pomena, saj se učinkovitost triaže brez vaj in izobraževanj hitro zmanjša, kar podpirajo tudi raziskave tujih avtorjev. Skupno lahko zaključimo, da sistematično, strukturirano in redno usposabljanje vseh prvih posredovalcev – ne glede na poklic – pomembno vpliva na uspešnost triaže v praksi ter lahko ključno prispeva k boljšemu odzivu na množične nesreče.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, zdravstvena nega, množične nesreče, algoritem SIEVE, znanje triaže, zdravstveni postopki, usposabljanje
• Vrsta gradiva: Diplomsko delo/naloga
• Tipologija: 2.11 - Diplomsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [Ž. Slak]
• Leto izida: 2025
• Št. strani: 39 str., [29] str. pril.
• PID: 20.500.12556/RUL-168867
• UDK: 616-083
• COBISS.SI-ID: 234700547
• Datum objave v RUL: 01.05.2025

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Assessment of primary triage knowledge among emergency medical service healthcare workers and professional firefighters : diploma work

Izvleček

Introduction: Mass casualty incidents pose a significant challenge to healthcare systems and emergency response services, as they involve a large number of casualties in a short time frame who must be rapidly assessed and prioritized for care. A key procedure in such situations is primary triage, which must be performed quickly, accurately, and in a coordinated manner. In Slovenia, the SIEVE triage algorithm is most commonly used. It enables fast and structured categorization of patients according to the severity of their condition. As professional firefighters are often among the first to arrive at the scene, they play a crucial role in the initial assessment and classification of casualties. In time-sensitive situations, their rapid and coordinated action significantly affects the course of the response. Cooperation between emergency services, especially between EMS teams and firefighters, is essential to ensure effective and safe management of casualties during a mass casualty incident. Purpose: The purpose of this thesis is to determine the level of knowledge about the implementation of primary triage in mass casualty incidents among healthcare workers in EMS and professional firefighters. Methods: A descriptive method and a quantitative cross-sectional research design were used. Data were collected through a structured questionnaire consisting of 20 simulated casualty scenarios. Respondents were asked to assign a triage category and select appropriate medical interventions according to the SIEVE algorithm. The survey was conducted via the 1KA online platform. Data analysis was performed using Excel and SPSS software. To compare the two groups, the T-test and Mann-Whitney U test were used, with statistical significance set at p < 0.05. Results: A total of 104 participants took part in the study (57 firefighters and 47 EMS healthcare workers). Professional firefighters achieved statistically better results in assigning triage categories using the SIEVE algorithm (92%) compared to healthcare workers (84%, p < 0.001). In the selection of appropriate medical interventions, the results were similar (firefighters 64.5%, healthcare workers 60%), with no statistically significant difference. The most common error was the selection of procedures that are not part of primary triage. Most respondents (92%) believe that more practical drills should be conducted to improve preparedness. Discussion and conclusion: Based on our research and a comparison with international literature, we found that properly trained professional firefighters can effectively perform primary triage using the SIEVE algorithm. Other studies have also shown that non-medical personnel, with appropriate training, can carry out triage efficiently, highlighting the importance of education and simulation. Our findings also revealed frequent selection of procedures not appropriate for primary triage. We confirmed that regular repetition of knowledge is essential, as the effectiveness of triage decreases significantly without continuous training, a point also supported by foreign studies. Overall, we conclude that systematic, structured, and regular training of all first responders – regardless of their professional background – has a major impact on triage performance in practice and can significantly improve response to mass casualty incidents.

• Ključne besede: diploma theses, nursing care, mass casualty incidents, SIEVE algorithm, triage knowledge, medical procedures, training