Akademik Veri Yönetim Sistemi
11th World Society of Emergency Surgery, Rodos, Yunanistan, 25 - 28 Haziran 2024, ss.1-2
Abstract
Introduction
As frontline responders to traumatic injuries, trauma surgeonsmust possess the ability to swiftly and decisively address life-threatening thoracic injuries, such as tension pneumothorax, cardiac tamponade, or massive hemothorax.
Moreover, resuscitative thoracotomy underscores theimportance of interdisciplinary collaboration and rapiddecision-making, skills that are paramount in the fast-pacedand unpredictable environment of trauma care.
By incorporating resuscitative thoracotomy into theirrepertoire, trauma surgeons bolster their capability to deliver optimal care to critically injured patients, reaffirming theirpivotal role in the multidisciplinary approach to traumamanagement. Resuscitative thoracotomy stands as a pivotal skill in the repertoire of any aspiring physician, particularlythose undergoing residency training. Through the mastery of resuscitative thoracotomy, residents not only cultivatetechnical expertise but also hone their ability to make swift, decisive judgments under immense pressure.
Methods and Results
In this study, a survey including questions about resuscitativethoracotomy skills was administered to 43 general surgeryresidents from Istanbul Faculty of Medicine. 16 of them wereresidents for more than 4 years, 8 of them were residents for3-4 years, 4 were residents for 2-3 years, 6 were residents for1-2 years, and 9 were residents for 0-1 year. 30 of them male, and the others was female. 6 residents were not familiar withthe theoretical aspects of resuscitative thoracotomy. Furthermore, 15 residents had never observed resuscitativethoracotomy being performed live. The number of a residentswho had witnessed resuscitative thoracotomy 7 or more timeswas 3. 19 residents had observed it 1-3 times, while 6 residents had observed it 4-6 times. Additionally, residentswere asked whether there was a difference in surgical skillacquisition between observing the procedure live versus viavideo. 31 individuals noted the existence of this difference. Consequently, they were asked whether they had previouslyperformed resuscitative thoracotomy as a primary operator. 33 (76%) individuals had never performed it, 9 (20%) had performed it 1-3 times, and 1 (4%) had performed it 7 or moretimes. Following this, residents were asked whether they couldperform this procedure with or without any support. 9 (21%) individuals stated they could perform it without any support, 19 (44.5%) individuals stated they could perform it withpartial support, 13 (30.5%) individuals stated they couldperform it with substantial support, and 2 (4%) individualsstated they could not perform it in any way.
Discussion
Upon reviewing the survey results, it was found thatapproximately half of the participants were resident physicianswith three or more years of experience (55%). This ratioensured a more homogeneous assessment of residentexperience in the survey results. Despite 35% of individualshaving observed the procedure live, only 20% of residentsstated that live observation made no difference. Additionally, only 25% of residents indicated that they could performresuscitative thoracotomy without any assistance. Resuscitative thoracotomy is a critical procedure that requiresurgent action, so it's crucial for the person doing it to be ableto do it quickly and accurately. The doctor needs to have theright skills and confidence. The survey results show thatdoctors are more likely to gain enough skill and confidence bywatching the procedure being done live compared to justlearning about it in theory. Also, the fact that similar numbersof assistants who have done the procedure before and thosewho feel confident they could do it if needed shows how important it is to gain experience by actually doing theprocedure. It highlights the critical role of gaining experiencethrough performing the procedure in enhancing the ability toperform resuscitative thoracotomy. Therefore, it's important toemphasize the live observation and performance of resuscitative thoracotomy during assistant training.