Trial document

This trial has been registered retrospectively.
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Trial Description

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The effect of paramedic training on pre-hospital trauma care. The prospective longitudinal mixed-methods EPPTC-trial

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Trial Acronym


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URL of the Trial


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Brief Summary in Lay Language

The aim of the study is to investigate the influence of education and medical teaching in the pre-hospital emergency medicine on the procedures of patient care and patient safety. Background is that a lot of training sessions are offered, but their influence and impact are largely unknown because the data are not representative.
In the present study, an assessment tool for the evaluation of processes, communication and working structure is first developed and validated. In the second step, all paramedics in the metropolitan region Wiesbaden be trained in structured care for serious injured patients and assesses the development and change by means of the assessment tool in video analysis during training at different times. It will put forward the hypothesis that, after appropriate training, patient care has a uniform structure and life-threatening symptoms are recognized quickly and the necessary interventions are made. In addition it is assumed that improvement will be seen in documentation, enhancement of the perceived safety of the participants and the corresponding patients will be transported in the right trauma centre (according to the guidelines of Traumanetzwerk DGU and the DGUV demands).

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Brief Summary in Scientific Language

Background: Accidents are the leading cause of death in adults prior to middle age. The
care of severely injured patients is an interdisciplinary challenge. Limited
evidence is available concerning pre-hospital trauma care training programs
and the advantage of such programs for trauma patients. The effect on trauma
care procedures or on the safety of emergency crews on the scene is limited;
however, there is a high level of experience and expert opinion.

Methods: I – Video-recorded case studies are the basis of an assessment tool and
checklist being developed to verify the results of programs to train
participants in the care of seriously injured patients, also known as “objective
structured clinical examination” (OSCE). The timing, completeness and quality
of the individual measures are assessed using appropriate scales. The
evaluation of team communication and interaction will be analyzed with
qualitative methods and quantified and verified by existing instruments (e.g.
the Clinical Team Scale). The developed assessment tool is validated by several
experts in the fields of trauma care, trauma research and medical education.
II a) In a German emergency medical service, the subjective assessment of
paramedics of their pre-hospital care of trauma patients is evaluated at three
time points, namely before, immediately after and one year after training. b)
The effect of a standardized course concept on the quality of documentation
in actual field operations is determined based on three items relevant to
patient safety before and after the course. c) The assessment tool will be used
to assess the effect of a standardized course concept on procedures and team
communication in pre-hospital trauma care using scenario-based case studies.

Discussion: This study explores the effect of training on paramedics. After successful study
completion, further multicenter studies are conceivable, which would evaluate
emergency-physician staffed teams. The influence on the patients and prehospital
measures should be assessed based on a retrospective analysis of the
emergency room data.

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Organizational Data

  •   DRKS00004713
  •   2014/02/13
  •   [---]*
  •   yes
  •   No approval required according to EC
  •   197/2013B02, Ethik-Kommission an der Medizinischen Fakultät der Eberhard-Karls-Universität und am Universitätsklinikum Tübingen
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Secondary IDs

  • [---]*
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Health Condition or Problem studied

  •   educational research
  •   T07 -  Unspecified multiple injuries
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Interventions/Observational Groups

  •   Participants will be evaluated using an assessment tool developed before and after the training with video analysis in their work structure, communication and processes.
    Participants will be interviewed in parallel to their subjective safety before and after training using questionnaires.
    The influence of training on the use of documentation at Real inserts is also before and are recognized after training.
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  •   Interventional
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  •   Single arm study
  •   Open (masking not used)
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  •   Uncontrolled/Single arm
  •   Health care system
  •   Single (group)
  •   N/A
  •   N/A
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Primary Outcome

Change in the structure and processes of patient care after appropriate training.
The changes detected by video analysis and evaluated using an assessment tool developed for this purpose.

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Secondary Outcome

- Increasing the subjective safety of the participants in the treatment of serious injured patients. Data is collected via questionnaire before and after the training.
- The documentation in real operations improved after the training. Evaluation of the use of protocols.

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Countries of Recruitment

  •   Germany
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Locations of Recruitment

  • other 
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  •   Actual
  •   2013/01/28
  •   375
  •   Monocenter trial
  •   National
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Inclusion Criteria

  •   Both, male and female
  •   18   Years
  •   no maximum age
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Additional Inclusion Criteria

Included in the study are all the employed paramedics and emergency medical technicians (EMTs) of the participating institutions of the emergency medical services of Wiesbaden and Rheingau-Taunus-Kreis.

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Exclusion Criteria

Excluded are all the participants not involved with the participating institutions.

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  • start of 1:1-Block address primary-sponsor
    • Berufsgenossenschaftliche Unfallklinik Ludwigshafen
    • Ludwig-Guttmann-Straße 13
    • 67071  Ludwigshafen
    • Germany
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    • Berufsgenossenschaftliche Unfallklinik Forschungsgruppe Schwerverletztenversorgung
    • Mr.  Dr. med.  Matthias  Münzberg 
    • Ludwig-Guttmann-Straße 13
    • 67071  Ludwigshafen
    • Germany
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    • Horst-Schmidt-Klinik: Gesundheitsamt - Amt 53, Landeshauptstadt Wiesbaden
    • Mr.  Marc  Dierhoff 
    • Ludwig-Erhard-Straße 100
    • 65199  Wiesbaden
    • Germany
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Sources of Monetary or Material Support

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    • Deutscher Berufsverband Rettungsdienst e.V. (DBRD)
    • Im Schlangengarten 52
    • 76877  Offenbach/Queich
    • Germany
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  •   Recruiting complete, follow-up complete
  •   2016/06/30
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Trial Publications, Results and other Documents

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* This entry means the parameter is not applicable or has not been set.