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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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https://www.readbyqxmd.com/read/28438222/hypothermia-in-trauma-victims-at-first-arrival-of-ambulance-personnel-an-observational-study-with-assessment-of-risk-factors
#1
Frédéric Lapostolle, James Couvreur, François Xavier Koch, Dominique Savary, Armelle Alhéritière, Michel Galinski, Jean-Luc Sebbah, Karim Tazarourte, Frédéric Adnet
BACKGROUND: Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. METHODS: This was an ancillary analysis of data recorded in the HypoTraum study, a prospective multicenter study conducted by the emergency medical services (EMS) of 8 hospitals in France. Inclusion criteria were: trauma victim, age over 18 years, and victim receiving prehospital care from an EMS team and transported to hospital by the EMS team in a medically equipped mobile intensive care unit...
April 24, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#2
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28410604/the-association-of-patient-and-trauma-characteristics-with-the-health-related-quality-of-life-in-a-dutch-trauma-population
#3
Amy Gunning, Mark van Heijl, Karlijn van Wessem, Luke Leenen
BACKGROUND: It is suggested in literature to use the Health Related Quality of Life (HRQoL) as an outcome indicator for evaluating trauma centre performances. In order to predict HRQoL, characteristics that could be of influence on a predictive model should be identified. This study identifies patient and injury characteristics associated with the HRQoL in a general trauma population. METHODS: Retrospective study of trauma patients admitted from 1st January 2007 through 31th December 2012...
April 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28407809/merger-of-two-dispatch-centres-does-it-improve-quality-and-patient-safety
#4
Alexandre Moser, Annette Mettler, Vincent Fuchs, Walter Hanhart, Claude-François Robert, Vincent Della Santa, Fabrice Dami
BACKGROUND: Dispatch centres (DCs) are considered an essential but expensive component of many highly developed healthcare systems. The number of DCs in a country, region, or state is usually based on local history and often related to highly decentralised healthcare systems. Today, current technology (Global Positioning System or Internet access) abolishes the need for closeness between DCs and the population. Switzerland went from 22 DCs in 2006 to 17 today. This study describes from a quality and patient safety point of view the merger of two DCs...
April 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28403868/the-use-of-viscoelastic-haemostatic-assays-in-goal-directing-treatment-with-allogeneic-blood-products-a-systematic-review-and-meta-analysis
#5
REVIEW
Mathilde Fahrendorff, Roberto S Oliveri, Pär I Johansson
BACKGROUND: Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopathy. The purpose of this meta-analysis was to systematically review and assess randomised controlled trials (RCTs) performed on patients in acute need for blood transfusions due to bleeding to evaluate the effect of viscoelastic haemostatic assay (VHA) guidance on bleeding, transfusion requirements and mortality...
April 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28399912/the-challenges-of-military-medical-education-and-training-for-physicians-and-nurses-in-the-nordic-countries-an-interview-study
#6
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
BACKGROUND: Development and use of e-learning has not taken place to the same extent in military medicine in the Nordic countries. The aim was to explore the similarities and differences in education and training in military medicine for health professionals in the Nordic countries, and more specifically to identify the specific challenges regarding education and training of military medicine, and how e-learning is used at present and the opportunities for the future. METHODS: Key educators within military medicine in the Nordic countries, as approved by the respective Surgeons General, were interviewed and the interviews were analyzed using content analysis...
April 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28399897/prehospital-ambulance-stroke-test-pilot-study-of-a-novel-stroke-test
#7
Gunnar Andsberg, Magnus Esbjörnsson, Arne Olofsson, Arne Lindgren, Bo Norrving, Mia von Euler
BACKGROUND: There is a need for a prehospital stroke test that in addition to high sensitivity for stroke, also is able to communicate stroke severity similar to the National Institute of Health Stroke Scale (NIHSS). METHODS: The PreHospital Ambulance Stroke Test (PreHAST), an eight item test based on NIHSS, which scores stroke severity from 0-19 points, was designed and adapted for the ambulance services. In the pilot study the ambulance nurses used PreHAST to assess patients with suspected stroke in the prehospital setting...
April 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28376849/effect-of-an-interactive-cardiopulmonary-resuscitation-assist-device-with-an-automated-external-defibrillator-synchronised-with-a-ventilator-on-the-cpr-performance-of-emergency-medical-service-staff-a-randomised-simulation-study
#8
Rainer Nitzschke, Christoph Doehn, Jan F Kersten, Julian Blanz, Tobias J Kalwa, Norman A Scotti, Jens C Kubitz
BACKGROUND: The present study evaluates whether the quality of advanced cardiac life support (ALS) is improved with an interactive prototype assist device. This device consists of an automated external defibrillator linked to a ventilator and provides synchronised visual and acoustic instructions for guidance through the ALS algorithm and assistance for face-mask ventilations. METHODS: We compared the cardiopulmonary resuscitation (CPR) quality of emergency medical system (EMS) staff members using the study device or standard equipment in a mannequin simulation study with a prospective, controlled, randomised cross-over study design...
April 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28359288/termination-of-prehospital-resuscitative-efforts-a-study-of-documentation-on-ethical-considerations-at-the-scene
#9
Søren Mikkelsen, Caroline Schaffalitzky de Muckadell, Lars Grassmé Binderup, Hans Morten Lossius, Palle Toft, Annmarie Touborg Lassen
BACKGROUND: Discussions on ethical aspects of life-and-death decisions within the hospital are often made in plenary. The prehospital physician, however, may be faced with ethical dilemmas in life-and-death decisions when time-critical decisions to initiate or refrain from resuscitative efforts need to be taken without the possibility to discuss matters with colleagues. Little is known whether these considerations regarding ethical issues in crucial life-and-death decisions are documented prehospitally...
March 31, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28356162/blood-transfusion-and-coagulopathy-in-geriatric-trauma-patients
#10
Brett Mador, Bartolomeu Nascimento, Simon Hollands, Sandro Rizoli
BACKGROUND: Trauma resuscitation has undergone a paradigm shift with new emphasis on the early use of blood products and increased proportions of plasma and platelets. However, it is unclear how this strategy is applied or how effective it is in the elderly population. The study aim is to identify differences in transfusion practices and the coagulopathy of trauma in the elderly. METHODS: Data was prospectively collected on all consecutive patients that met trauma activation criteria at a Level I trauma centre...
March 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28356134/external-validation-of-the-rosc-after-cardiac-arrest-raca-score-in-a-physician-staffed-emergency-medical-service-system
#11
Petteri Kupari, Markus Skrifvars, Markku Kuisma
BACKGROUND: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. METHODS: We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated...
March 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28335785/we-need-to-include-bystander-first-aid-in-trauma-research
#12
Håkon Kvåle Bakke, Torben Wisborg
BACKGROUND: The chain of trauma survival is a concept that originated in the area of out-of-hospital cardiac arrest (OHCA) and was adapted to the treatment of trauma. In out-of-hospital cardiac arrest research into bystander first aid has resulted in improved outcome. Whereas, in trauma research the first link of the chain of survival is almost ignored. METHODS: In OHCA, cardiopulmonary resuscitation (CPR) from bystanders has been subject of a vast amount of research, as well as measures and programs to raise the rate of bystander CPR to cardiac arrest victims...
March 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28302139/targeted-temperature-management-in-cardiac-arrest-survival-evaluated-by-propensity-score-matching
#13
Eirik A Buanes, Karl O Hufthammer, Jørund Langørgen, Anne-Berit Guttormsen, Jon-Kenneth Heltne
BACKGROUND: Targeted temperature management in cardiac arrest was introduced following evidence of increased survival from two controlled trials published in 2002. We wanted to investigate whether the introduction of targeted temperature management to clinical practice had increased the survival of cardiac arrest patients at Haukeland University Hospital, Norway. METHODS: We included 336 unresponsive patients admitted to the emergency department between December 2003 and December 2008 with return of spontaneous circulation following out-of-hospital cardiac arrest in the analysis...
March 16, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28292321/prothrombin-time-is-predictive-of-low-plasma-prothrombin-concentration-and-clinical-outcome-in-patients-with-trauma-hemorrhage-analyses-of-prospective-observational-cohort-studies
#14
Clare A Balendran, Ann Lövgren, Kenny M Hansson, Karin Nelander, Marita Olsson, Karin J Johansson, Karim Brohi, Dietmar Fries, Anders Berggren
BACKGROUND: Fibrinogen and prothrombin have been suggested to become rate limiting in trauma associated coagulopathy. Administration of fibrinogen is now recommended, however, the importance of prothrombin to patient outcome is unknown. METHODS: We have utilized two trauma patient databases (database 1 n = 358 and database 2 n = 331) to investigate the relationship of plasma prothrombin concentration on clinical outcome and coagulation status. Database 1 has been used to assess the relationship of plasma prothrombin to administered packed red blood cells (PRBC), clinical outcome and coagulation biomarkers (Prothrombin Time (PT), ROTEM EXTEM Coagulation Time (CT) and Maximum Clot Firmness (MCF))...
March 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28270170/effect-and-accuracy-of-emergency-dispatch-telephone-guidance-to-bystanders-in-trauma-post-hoc-analysis-of-a-prospective-observational-study
#15
Håkon Kvåle Bakke, Tine Steinvik, Håkon Ruud, Torben Wisborg
BACKGROUND: Emergency medical communication centres (EMCCs) dispatch and allocate ambulance resources, and provide first-aid guidance to on-scene bystanders. We aimed to 1) evaluate whether dispatcher guidance improved bystander first aid in trauma, and 2) to evaluate whether dispatchers and on-scene emergency medical services (EMS) crews identified the same first aid measures as indicated. METHODS: For 18 months, the crew on the first EMS crew responding to trauma calls used a standard form to assess bystander first aid...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28270166/the-laboratory-risk-indicator-for-necrotizing-fasciitis-lrinec-scoring-the-diagnostic-and-potential-prognostic-role
#16
Ayman El-Menyar, Mohammad Asim, Insolvisagan N Mudali, Ahammed Mekkodathil, Rifat Latifi, Hassan Al-Thani
BACKGROUND: Necrotizing fasciitis (NF) is a devastating soft tissue infection associated with potentially poor outcomes. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has been introduced as a diagnostic tool for NF. We aimed to evaluate the prognostic value of LRINEC scoring in NF patients. METHODS: A retrospective analysis was conducted for patients who were admitted with NF between 2000 and 2013. Based on LRINEC points, patients were classified into (Group 1: LRINEC < 6 and Group 2: LRINEC ≥ 6)...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28264690/presentations-to-an-urban-emergency-department-in-bern-switzerland-associated-with-acute-recreational-drug-toxicity
#17
Evangelia Liakoni, Sabine Müller, Adrian Stoller, Meret Ricklin, Matthias E Liechti, Aristomenis K Exadaktylos
BACKGROUND: Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. METHODS: Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28264700/the-haemodynamic-dilemma-in-emergency-care-is-fluid-responsiveness-the-answer-a-systematic-review
#18
REVIEW
Mohammed H Elwan, Ashraf Roshdy, Eman M Elsharkawy, Salah M Eltahan, Timothy J Coats
BACKGROUND: Fluid therapy is a common and crucial treatment in the emergency department (ED). While fluid responsiveness seems to be a promising method to titrate fluid therapy, the evidence for its value in ED is unclear. We aim to synthesise the existing literature investigating fluid responsiveness in ED. METHODS: MEDLINE, Embase and the Cochrane library were searched for relevant peer-reviewed studies published from 1946 to present. RESULTS: A total of 249 publications were retrieved of which 22 studies underwent full-text review and eight relevant studies were identified...
March 6, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28259184/can-we-rely-on-out-of-hospital-blood-samples-a-prospective-interventional-study-on-the-pre-analytical-stability-of-blood-samples-under-prehospital-emergency-medicine-conditions
#19
Johannes Prottengeier, Nicola Jess, Frank Harig, Christine Gall, Joachim Schmidt, Torsten Birkholz
BACKGROUND: Prehospital intravenous access provides the opportunity to sample blood from an emergency patient at the earliest possible moment in the course of acute illness and in a state prior to therapeutic interventions. Our study investigates the pre-analytical stability of biomarkers in prehospital emergency medicine and will answer the question whether an approach of blood sampling out in the field will deliver valid laboratory results. METHODS: We prepared pairs of blood samples from healthy volunteers and volunteering patients post cardio-thoracic surgery...
March 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28253928/presentations-of-adult-septic-patients-in-the-prehospital-setting-as-recorded-by-emergency-medical-services-a-mixed-methods-analysis
#20
Ulrika Margareta Wallgren, Katarina Eva Margareta Bohm, Lisa Kurland
BACKGROUND: Current sepsis screening tools rely on vital parameters which are, however, normal in one third of patients with serious infections. Therefore, there is a need to include other variables than vital parameters to identify septic patients. Our primary aim was to identify and quantify keywords related to the septic patients' symptom presentation in the prehospital setting. The secondary aims were to compare keywords in relation to in-hospital mortality and the distribution of keywords in relation to age categories, survivors/ deceased and severe/ non-severe sepsis...
March 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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