Background A debate regarding the potential harmful effects of rigid neck collar and backboard usage among prehospital and hospital care providers in Norway provoked the development of an evidence-based guideline. “The Norwegian guideline for the prehospital management of adult trauma patients with potential spinal injury” was developed with rigorous scientific methods and published in 2016. An e-learning course was developed in parallel. The aim of this study is to explore whether emergency medical services personnel in Norway have implemented the guideline, and to what extent the e-learning course was applied during the implementation process. Method An electronic survey was distributed individually to registered prehospital personnel in Norway 18 months after publication of the guideline. Results In all, 938 of 5500 (17%) EMS personnel responded to the survey. More than one-half confirmed knowledge of the guideline; among these, 56% claimed that the guideline was implemented in the service they work. Not having responded to trauma cases in real life was the main reason for not having executed the guideline. The e-learning course had been completed by 18% of respondents. Conclusion Although the guideline has not been authorized or made compulsory by national authorities, one-half of respondents with knowledge of the guideline reported it as implemented. E-learning did not seem to have affected the implementation. The guideline was developed based on perceived needs among care providers, and this probably facilitated implementation of the guideline. Electronic supplementary material The online version of this article (10.1186/s13049-019-0660-0) contains supplementary material, which is available to authorized users.
Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: idé, utforming/design, datainnsamling, li eratursøk, utarbeiding og revisjon av manus samt godkjenning av innsendte manusversjon. Nina Øye Thorvaldsen er universitetslektor. Hun er sykepleier med mange års erfaring fra paramedic-arbeid, hovedsakelig fra ambulanseavdelingen, Oslo universitetssykehus. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: idé, utarbeiding og revisjon av manus samt godkjenning av innsendte manusversjon. Anne Kristine Bergem er spesialist i psykiatri og førstelektor II. Hun er spesialrådgiver i Norsk psykiatrisk forening og har videreutdanning i voldsrisikovurdering og -håndtering. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. SIFER -Nasjonalt kompetansene verk for sikkerhets-, fengsels-og re spsykiatri Oslo universitetssykehus og Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: li eratursøk, utarbeiding og revisjon av manus samt godkjenning av innsendte manusversjon. Øyvind Holst er ph.d., cand.jur., juridisk rådgiver og førsteamanuensis. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: utforming/design, analyse, utarbeiding og revisjon av manus samt godkjenning av innsendte manusversjon. Kristin Häikiö har ph.d. innen helsevitenskap og helsetjenesteforskning og er førsteamanuensis. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.
Objective: Recent terror attacks led the Norwegian government to develop a procedure for emergency and law enforcement services cooperation during Active Violent Incidents (AVI, abbreviated PLIVO in Norwegian). To address further national initiatives to improve preparedness for mass casualty events and penetrating injuries among emergency medical services (EMS) in Norway, training and equipment status were mapped. Methods: All EMS regions in Norway were invited to participate in an electronic nation-wide survey about practical medical training in PLIVO scenario training and specific training in hemorrhage control and penetrating injuries. Results: Ninety percent (842/938) had attended at least 1 PLIVO training scenario. Of these, 76% (642/938) reported only evacuation training during the exercise, while only 20% (168/938) had practiced hemorrhage control. Eighty-one percent (760/938) respondents reported that they were equipped with tourniquets and 91% (853/938) were equipped with gauze to pack wounds. However, only 52% (487/938) and 48% (450/938) reported practical training in tourniquet application and wound packing, respectively, while 30% (280/938) reported that they had no training or only theoretical education in tourniquet application. Supervised practical training on penetrating thoracic injuries was reported by <20%, and <50% reported practical training in needle decompression of a tension pneumothorax. Conclusions: Enhanced focus on training in hemorrhage control and penetrating injuries is needed. This supports the recent decision from the Norwegian government to strengthen the training for EMS in AVI (PLIVO) exercises, by focusing on medical procedures in addition to evacuation training. Although the estimated response rate is 17%, we believe the large number of respondents still make the results valuable.
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