Articoli originali Open access

Conoscenze, competenze e formazione degli infermieri del soccorso pre-ospedaliero sulle filosofie del trasporto: una survey

Autori

Pubblicato
21 maggio 2026
Fascicolo
V. 43 N. 2 (2026)
Sezione
Articoli originali
DOI
10.4081/scenario.2026.630

Abstract

Introduzione: sul territorio nazionale italiano si riconoscono diverse metodologie di soccorso extraospedaliero, allo scopo di migliorare l'assistenza e il trasporto di pazienti con malattie o lesioni critiche sensibili al fattore tempo. L’obiettivo di questo studio è indagare le conoscenze, la formazione e le competenze autoriferite degli infermieri impiegati nell’ambito dell’Emergenza Sanitaria preospedaliera sul territorio italiano, in riferimento alle diverse modalità di gestione di soccorso e trasporto.

Materiali e Metodi: è stata condotta un’indagine osservazionale multicentrica tramite una Web-Survey somministrata a infermieri italiani operanti nel soccorso preospedaliero È stata condotta un’analisi descrittiva mediante frequenze, percentuali, media e deviazione standard, e un’analisi inferenziale mediante correlazioni non parametriche di Spearman (IBM-SPSS ver. 26).

Risultati: un campione di 208 infermieri ha aderito alla survey. Il 96% degli infermieri ha dichiarato di conoscere le modalità scoop and run e stay and play, ma il 77% degli infermieri non le attuerebbe nel trauma e/o in una situazione di shock. Le conoscenze e competenze degli infermieri del soccorso preospedaliero sullo shock e sulle modalità di trasporto risultano carenti, nonostante più del 70% degli infermieri abbia svolto corsi di formazione relativi a trauma, shock e sulle modalità di trasporto.

Conclusioni: la survey evidenzia lacune conoscitive e applicative sulle strategie di trasporto nel trauma/shock, nonostante l’ampia esposizione formativa dichiarata. Le differenze per area geografica ed esperienza si inseriscono in un sistema 118 strutturalmente eterogeneo, con modelli organizzativi e standard formativi non uniformi. I risultati supportano la necessità di percorsi formativi continuativi e di criteri minimi condivisi per competenze e pratiche nel soccorso preospedaliero.

 

Parole chiave

Riferimenti bibliografici

  1. 1. Mehmood A, Rowther AA, Kobusingye O, Hyder AA. Assessment of pre-hospital emergency medical services in low-income settings using a health systems approach. Int J Emerg Med 2018:11:53.
  2. 2. Spoelder EJ, Slagt C, Scheffer GJ, van Geffen GJ. Transport of the patient with trauma: a narrative review. Anaesthesia 2022;77:1281-7.
  3. 3. Lidal IB, Holte HH, Vist GE. Triage systems for pre-hospital emergency medical services - a systematic review. Scand J Trauma Resusc Emerg Med 2013;21:28.
  4. 4. Dijkink S, Nederpelt CJ, Krijnen P, et al. Trauma systems around the world: A systematic overview. J Trauma Acute Care Surg 2017;83:917-25.
  5. 5. Doucet J, Bulger E, Sanddal N, et al. Appropriate use of helicopter emergency medical services for transport of trauma patients: guidelines from the Emergency Medical System Subcommittee, Committee on Trauma, American College of Surgeons. J Trauma Acute Care Surg 2013;75:734-41.
  6. 6. Smith RM, Conn AK. Prehospital care - scoop and run or stay and play? Injury 2009;40:S23-26.
  7. 7. Chen CH, Shin SD, Sun JT, et al. Association between prehospital time and outcome of trauma patients in 4 Asian countries: A cross-national, multicenter cohort study. PLoS Med 2020;17:e1003360.
  8. 8. Gristina G, Pulice E. Il sistema sanitario di emergenza italiano tra prove e rischi di corporativismo: il “caso Bologna”. Parte I: le prove / Parte II: deontologia e diritto. Recenti Prog Med 2019;110:168-87.
  9. 9. Van den Brande Ruben FR, Synnot A. Stay and play vs. scoop and run in trauma care: a systematic review. Int J Care Scholars 2014;5:79-94.
  10. 10. Nirula R, Maier R, Moore E, et al. Scoop and run to the trauma center or stay and play at the local hospital: hospital transfer's effect on mortality. J Trauma 2010;69:595-9; discussion 599-601.
  11. 11. Verdonck P, Peters M, Stroobants T, et al. Effects of major trauma care organisation on mortality in a European level 1 trauma centre: A retrospective analysis of 2016-2023. Injury 2024;55:112022.
  12. 12. Penn J, McAleer R, Ziegler C, et al. Effectiveness of prehospital critical care scene response for major trauma: a systematic review. Prehosp Emerg Care 2026;30:309-22.
  13. 13. Dinh M, Singh H, Deans C, et al. Prehospital times and outcomes of patients transported using an ambulance trauma transport protocol: A data linkage analysis from New South Wales Australia. Injury 2023;54:110988.
  14. 14. Burns B, Hsu HR, Keech A, et al. Expedited transport versus continued on-scene resuscitation for refractory out-of-hospital cardiac arrest: A systematic review and meta-analysis. Resusc Plus 2023;16:100482.
  15. 15. Pham H, Puckett Y, Dissanaike S. Faster on-scene times associated with decreased mortality in Helicopter Emergency Medical Services (HEMS) transported trauma patients. Trauma Surg Acute Care Open 2017;2:e000122.
  16. 16. Ahmed Eid SH, Taha NM, Zatton HK. Nurses’ knowledge and practice of trauma patients during golden hours of care. Zagazig Nurs J 201713:244-57.
  17. 17. Clements R, Mackenzie R. Competence in prehospital care: evolving concepts. Emerg Med J 2005;22:516-9.
  18. 18. Nandasena G, Abeysena C. Knowledge, attitudes and skills of doctors, nurses and emergency medical technicians in pre-hospital care and emergency medicine who accompany patients in ambulances which arrive at the National Hospital of Sri Lanka. Int J Clin Anesth Res 2018;2:38-43.
  19. 19. Jansson J. Prehospital nurses’ professional competence–utilization and development. Karlstads universitet, 2023.
  20. 20. Shrestha B, Dunn L. The Declaration of Helsinki on Medical Research involving Human Subjects: A Review of Seventh Revision. J Nepal Health Res Counc 2020;17:548-52.
  21. 21. Rowe JA. Accountability: a fundamental component of nursing practice. Br J Nurs 2000;9:549-52.
  22. 22. Hall A. Defining nursing knowledge. Nurs Times 2005;101:34-7.
  23. 23. Elias CE, Day T. Experiences of newly qualified nurses in critical care: a qualitative systematic review. J Intensive Care Soc 2020;21:334-43.
  24. 24. Celik S, Tasdemir N, Kurt A, et al. Fatigue in intensive care nurses and related factors. Int J Occup Environ Med 2017;8:199-206.
  25. 25. Alharbi RJ, Shrestha S, Lewis V, Miller C. The effectiveness of trauma care systems at different stages of development in reducing mortality: a systematic review and meta-analysis. World J Emerg Surg 2021;16:38.
  26. 26. Taran S. The scoop and run method of pre-clinical care for trauma victims. Mcgill J Med 2009;12:73.
  27. 27. Greenspan L, McLellan BA, Greig H. Abbreviated injury scale and injury severity score: a scoring chart. J Trauma 1985;25:60-4.
  28. 28. Hussmann B, Lendemans S. Pre-hospital and early in-hospital management of severe injuries: changes and trends. Injury 2014;45:S39-42.
  29. 29. Ramesh GH, Uma JC, Farhath S. Fluid resuscitation in trauma: what are the best strategies and fluids? Int J Emerg Med 2019;12:38.
  30. 30. Nishi K, Takasu A, Shinozaki H, et al. Hemodilution as a result of aggressive fluid resuscitation aggravates coagulopathy in a rat model of uncontrolled hemorrhagic shock. J Trauma Acute Care Surg 2013;74:808-12.
  31. 31. Geeraedts LM Jr, Pothof LA, Caldwell E, et al. Prehospital fluid resuscitation in hypotensive trauma patients: do we need a tailored approach? Injury 2015;46:4-9.
  32. 32. Haut ER, Kalish BT, Cotton BA, et al. Prehospital intravenous fluid administration is associated with higher mortality in trauma patients: a National Trauma Data Bank analysis. Ann Surg 2011;253:371-7.
  33. 33. Wallace HA, Regunath H. Fluid Resuscitation. In StatPearls; Treasure Island (FL) ineligible companies. Disclosure: Hariharan Regunath declares no relevant financial relationships with ineligible companies., 2025.
  34. 34. McMullan J, Curry BW, Calhoun D, et al. Prehospital trauma compendium: fluid resuscitation in trauma - a position statement and resource document of NAEMSP. Prehosp Emerg Care 2024, 1-11, doi:10.1080/10903127.2024.2433146.
  35. 35. Ziu E, Mesfin FB, Evans KA. Spinal Shock (Nursing). In StatPearls; Treasure Island (FL), 2023.
  36. 36. Almomani MH, Khater WA, Qasem BAA, Joseph RA. Nurses' knowledge and practices of physical restraints in intensive care units: An observational study. Nurs Open 2021;8:262-72.
  37. 37. Brigolini G, Ciconet RM. Restricted movement of the spine: an analysis of the knowledge of nursing professionals. Cogitare Enfermagem 2023;28:e87844.
  38. 38. Tartaglione M, Carenzo L, Gamberini L, et al. Multicentre observational study on practice of prehospital management of hypotensive trauma patients: the SPITFIRE study protocol. BMJ Open 2022;12:e062097.
  39. 39. Sperry JL, Guyette FX, Adams PW. Prehospital plasma during air medical transport in trauma patients. N Engl J Med 2018;379:1783.
  40. 40. Romanelli D, Farrell MW. AVPU Score. In StatPearls; Treasure Island (FL), 2023.
  41. 41. Janagama SR, Newberry JA, Kohn MA, et al. Is AVPU comparable to GCS in critical prehospital decisions? - A cross-sectional study. Am J Emerg Med 2022;59:106-10.
  42. 42. Beuran M, Paun S, Gaspar B, et al. Prehospital trauma care: a clinical review. Chirurgia (Bucur) 2012;107:564-70.

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