Entwicklung und Validierung eines Kurskonzepts zur medizinisch-taktischen Rettung unter Tage: Standardisiertes Ausbildungscurriculum für Grubenwehren

BACKGROUND: Structural changes in modern mining industry increase the potential for medical emergencies. Furthermore, rescue times in mining are prolonged and public medical resources are not consistently available. OBJECTIVES: We sought to train mine rescue brigade lay people to cover medical emergencies in mining. MATERIALS AND METHODS: A standardized tactical–medical approach including specific equipment was developed and taught in a didactically optimized way in 16 lessons. Objective Structured Practical Examinations (OSPE) were conducted in 3 groups of 4 mine rescue personnel and compared to the identical exam of the reference group (17 paramedics of different educational and experience levels). RESULTS: The tactical–medical scheme includes vital functions and body checks, advanced life support, nasal and intraosseous drug administration, airway management, thoracocentesis, bleeding control, tourniquet, fracture repositioning, splinting and transport bedding. In OSPE evaluation, the scores of the trained mine rescue personnel (mean [M] = 3.42, 95% confidence interval [CI(95%)] = [3.24; 3.60]) were statistically equal to those of advanced paramedics (M = 3.28, CI(95%) = [3.09; 3.46]), but much better than basic German paramedic level (M = 2.43, CI(95%) = [2.10; 2.77]). Competency retention of mine rescue personnel remained on the same level after a period of 6 months without further training (M = 3.54, CI(95%) = [3.31; 3.73]). CONCLUSION: The competency level after the Tactical Mining Rescue Course is comparable to the advanced paramedics level in the spectrum of competencies addressed. Medical lay people can be trained to deliver an acceptable treatment level within a clearly defined treatment algorithm, and thus potentially close the gap towards professional medical emergency rescue in mining.