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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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https://www.readbyqxmd.com/read/27919274/altered-pharmacological-effects-of-adrenergic-agonists-during-hypothermia
#1
REVIEW
Erik Sveberg Dietrichs, Georg Sager, Torkjel Tveita
Rewarming from accidental hypothermia is often complicated by hypothermia-induced cardiac dysfunction, calling for immediate pharmacologic intervention. Studies show that although cardiac pharmacologic support is applied when rewarming these patients, a lack of updated treatment recommendations exist. Mainly due to lack of clinical and experimental data, neither of the international guidelines includes information about pharmacologic cardiac support at temperatures below 30 °C. However, core temperature of accidental hypothermia patients is often reduced below 30 °C...
December 5, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27912778/medical-priority-dispatch-codes-comparison-with-national-early-warning-score
#2
Marko Hoikka, Sami Länkimäki, Tom Silfvast, Tero I Ala-Kokko
BACKGROUND: In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories-from A (highest risk) to D (lowest risk)-following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leading to inappropriate use of emergency medical services units and to risk underestimation that can negatively impact patient outcome. To evaluate dispatch protocol accuracy, we assessed association between priority assigned at dispatch and the patient's condition assessed by emergency medical services on the scene using an early warning risk assessment tool...
December 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27912777/warming-the-head-of-hypothermic-patient-is-it-always-safe
#3
LETTER
Paweł Podsiadło, Tomasz Darocha, Sylweriusz Kosiński
The head warming in hypothermic victims is an alternative way of heat donation, which does not inhibit shivering and does not impede the access to the patient's chest. It seems to be a safe method in mild hypothermia. The authors of the review article "Accidental hypothermia - an update" suggest this way of heat donation, without indicating precisely, in which group of patients it can be applied. In severe hypothermia, the brain-protective effect of cold is well known. The decreased need of oxygen allows good neurological outcome after long lasting cardiac arrest...
December 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27899124/outcomes-after-helicopter-versus-ground-emergency-medical-services-for-major-trauma-propensity-score-and-instrumental-variable-analyses-a-retrospective-nationwide-cohort-study
#4
Asuka Tsuchiya, Yusuke Tsutsumi, Hideo Yasunaga
BACKGROUND: Because of a lack of randomized controlled trials and the methodological weakness of currently available observational studies, the benefits of helicopter emergency medical services (HEMS) over ground emergency medical services (GEMS) for major trauma patients remain uncertain. The aim of this retrospective nationwide cohort study was to compare the mortality of adults with serious traumatic injuries who were transported by HEMS and GEMS, and to analyze the effects of HEMS in various subpopulations...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27899118/surgical-intervention-for-paediatric-liver-injuries-is-almost-history-a-12-year-cohort-from-a-major-scandinavian-trauma-centre
#5
Tomohide Koyama, Jorunn Skattum, Peder Engelsen, Torsten Eken, Christine Gaarder, Pål Aksel Naess
BACKGROUND: Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. METHODS: Patients <17 years old with liver injury admitted to Oslo University Hospital Ullevaal during the period 2002-2013 were retrospectively reviewed...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27894327/a-statistical-analysis-protocol-for-the-time-differentiated-target-temperature-management-after-out-of-hospital-cardiac-arrest-tth48-clinical-trial
#6
Hans Kirkegaard, Asger Roer Pedersen, Ville Pettilä, Jakob Hjort, Bodil Steen Rasmussen, Inge de Haas, Jørgen Feldbæk Nielsen, Susanne Ilkjær, Anne Kaltoft, Anni Nørgaard Jeppesen, Anders Morten Grejs, Christophe Henri Valdemar Duez, Alf Inge Larsen, Valdo Toome, Urmet Arus, Fabio Silvio Taccone, Christian Storm, Timo Laitio, Markus B Skrifvars, Eldar Søreide
BACKGROUND: The TTH48 trial aims to determine whether prolonged duration (48 hours) of targeted temperature management (TTM) at 33 (±1) °C results in better neurological outcomes compared to standard duration (24 hours) after six months in comatose out-of-hospital cardiac arrest (OHCA) patients. METHODS: TTH48 is an investigator-initiated, multicentre, assessor-blinded, randomised, controlled superiority trial of 24 and 48 hours of TTM at 33 (±1) ° C performed in 355 comatose OHCA patients aged 18 to 80 years who were admitted to ten intensive care units (ICUs) in six Northern European countries...
November 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27881175/do-emergency-medicine-journals-promote-trial-registration-and-adherence-to-reporting-guidelines-a-survey-of-instructions-for-authors
#7
Matthew T Sims, Nolan M Henning, C Cole Wayant, Matt Vassar
BACKGROUND: The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of emergency medicine journals. METHODS: We performed a web-based data abstraction from the "Instructions for Authors" of the 27 Emergency Medicine journals catalogued in the Expanded Science Citation Index of the 2014 Journal Citation Reports and Google Scholar Metrics h5-index to identify whether each journal required, recommended, or made no mention of the following reporting guidelines: EQUATOR Network, ICMJE, ARRIVE, CARE, CONSORT, STARD, TRIPOD, CHEERS, MOOSE, STROBE, COREQ, SRQR, SQUIRE, PRISMA-P, SPIRIT, PRISMA, and QUOROM...
November 24, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27876077/post-traumatic-acute-kidney-injury-a-cross-sectional-study-of-trauma-patients
#8
Wei-Hung Lai, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Ching-Hua Hsieh, Hsiao-Yun Hsieh
BACKGROUND: The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. METHODS: Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System...
November 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27842599/team-talk-and-team-activity-in-simulated-medical-emergencies-a-discourse-analytical-approach
#9
Stine Gundrosen, Ellen Andenæs, Petter Aadahl, Gøril Thomassen
BACKGROUND: Communication errors can reduce patient safety, especially in emergency situations that require rapid responses by experts in a number of medical specialties. Talking to each other is crucial for utilizing the collective expertise of the team. Here we explored the functions of "team talk" (talking between team members) with an emphasis on the talk-work relationship in interdisciplinary emergency teams. METHODS: Five interdisciplinary medical emergency teams were observed and videotaped during in situ simulations at an emergency department at a university hospital in Norway...
November 14, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27842564/heel-pressure-ulcer-prevention-and-predictors-during-the-care-delivery-chain-when-and-where-to-take-action-a-descriptive-and-explorative-study
#10
Åsa Muntlin Athlin, Maria Engström, Lena Gunningberg, Carina Bååth
BACKGROUND: Hazardous healthcare settings, for example acute care, need to focus more on preventing adverse events and preventive actions across the care delivery chain (i.e pre-hospital and emergency care, and further at the hospital ward) should be more studied. Pressure ulcer prevalence is still at unreasonably high levels, causing increased healthcare costs and suffering for patients. Recent biomedical research reveals that the first signs of cell damage could arise within minutes...
November 14, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27821129/traumatic-brain-injury-patient-volume-and-mortality-in-neurosurgical-intensive-care-units-a-finnish-nationwide-study
#11
Rahul Raj, Stepani Bendel, Matti Reinikainen, Sanna Hoppu, Teemu Luoto, Tero Ala-Kokko, Sami Tetri, Ruut Laitio, Timo Koivisto, Jaakko Rinne, Riku Kivisaari, Jari Siironen, Markus B Skrifvars
BACKGROUND: Differences in outcomes after traumatic brain injury (TBI) between neurosurgical centers exist, although the reasons for this are not clear. Thus, our aim was to assess the association between the annual volume of TBI patients and mortality in neurosurgical intensive care units (NICUs). METHODS: We collected data on all patients treated in the five Finnish university hospitals to examine all patients with TBI treated in NICUs in Finland from 2009 to 2012...
November 8, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27821147/hemodynamic-management-and-outcomes-of-patients-admitted-to-emergency-department-with-heart-failure
#12
Pierre-Géraud Claret, Ian G Stiell, Justin W Yan, Catherine M Clement, Brian H Rowe, Lisa A Calder, Jeffrey J Perry
BACKGROUND: Heart failure is one of the leading reasons for hospitalization in developed countries. Our goal was to describe the hemodynamic vital signs (heart rate and systolic blood pressure) of patients presenting to the emergency department (ED) with heart failure and to describe the frequency of adverse events for patients presenting with various heart rate and systolic blood pressure values. METHOD: We conducted two prospective cohort studies of heart failure conducted at six Canadian teaching hospital sites and this study was a secondary analysis of these data...
November 7, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27809922/analysis-of-thromboelastography-pt-aptt-and-fibrinogen-in-intraosseous-and-venous-samples-an-experimental-study
#13
Gunnar Strandberg, Miklós Lipcsey, Mats Eriksson, Norbert Lubenow, Anders Larsson
BACKGROUND: Laboratory analysis of coagulation is often important in emergencies. If vascular access is challenging, intraosseous catheterization may be necessary for treatment. We studied the analysis of coagulation parameters in intraosseous aspirate during stable conditions and after major haemorrhage in a porcine model. METHODS: Ten anesthetized pigs received central venous and intraosseous catheters and samples were taken for analysis of thromboelastography (TEG), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen concentration...
November 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27809885/which-score-should-be-used-for-posttraumatic-multiple-organ-failure-comparison-of-the-mods-denver-and-sofa-scores
#14
Matthias Fröhlich, Arasch Wafaisade, Anastasios Mansuri, Paola Koenen, Christian Probst, Marc Maegele, Bertil Bouillon, Samir G Sakka
BACKGROUND: Multiple organ dysfunction and multiple organ failure (MOF) is still a major complication and challenge in the treatment of severely injured patients. The incidence varies decisively in current studies, which complicates the comparability regarding risk factors, treatment recommendations and patients' outcome. Therefore, we analysed how the currently used scoring systems, the MODS, Denver- and SOFA Score, influence the definition and compared the scores' predictive ability...
November 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27793208/myocardial-function-at-the-early-phase-of-traumatic-brain-injury-a-prospective-controlled-study
#15
Adrien Cuisinier, Claire Maufrais, Jean-François Payen, Stephane Nottin, Guillaume Walther, Pierre Bouzat
BACKGROUND: The concept of brain-heart interaction has been described in several brain injuries. Traumatic brain injury (TBI) may also lead to cardiac dysfunction but evidences are mainly based upon experimental and clinical retrospective studies. METHODS: We conducted a prospective case-control study in a level I trauma center. Twenty consecutive adult patients with severe TBI were matched according to age and gender with 20 control patients. The control group included adult patients undergoing a general anesthesia for a peripheral trauma surgery...
October 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27793168/physical-function-and-pain-after-surgical-or-conservative-management-of-multiple-rib-fractures-a-follow-up-study
#16
Monika Fagevik Olsén, Margareta Slobo, Lena Klarin, Eva-Corina Caragounis, David Pazooki, Hans Granhed
BACKGROUND: There is scarce knowledge of physical function and pain due to multiple rib fractures following trauma. The purpose of this follow-up was to assess respiratory and physical function, pain, range of movement and kinesiophobia in patients with multiple rib fractures who had undergone stabilizing surgery and compare with conservatively managed patients. METHODS: A consecutive series of 31 patients with multiple rib fractures who had undergone stabilizing surgery were assessed >1 year after the trauma concerning respiratory and physical function, pain, range of movement in the shoulders and thorax, shoulder function and kinesiophobia...
October 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27756343/the-recapta-study-a-prospective-out-of-hospital-cardiac-arrest-registry-including-multiple-sources-of-surveillance-for-the-study-of-sudden-cardiac-death-in-the-mediterranean-area
#17
Youcef Azeli, Eneko Barbería, María Jiménez-Herrera, Gil Bonet, Eva Valero-Mora, Alfonso Lopez-Gomariz, Isaac Lucas-Guarque, Alex Guillen-Lopez, Carlos Alonso-Villaverde, Inés Landín, Pilar Torralba, Ali Jammoul, Jordi Bladé-Creixenti, Christer Axelsson, Alfredo Bardají
BACKGROUND: Cardiovascular diseases are one of the leading causes of death in the industrialized world. Sudden cardiac death is very often the first manifestation of the disease and it occurs in the prehospital setting. The determination of the sudden cardiac death phenotype is challenging. It requires prospective studies in the community including multiple sources of case ascertainment that help to identify the cause and circumstances of death. The aim of the Clinical and Pathological Registry of Tarragona (ReCaPTa) is to study incidence and etiology of Sudden Cardiac Death in the Tarragona region (Catalonia, Spain)...
October 19, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27756416/agreement-between-triage-category-and-patient-s-perception-of-priority-in-emergency-departments
#18
Ghasem-Sam Toloo, Peter Aitken, Julia Crilly, Gerry FitzGerald
BACKGROUND: Patients attending hospital emergency departments (ED) commonly cite the urgency and severity of their condition as the main reason for choosing the ED. However, the patients' perception of urgency and severity may be different to the nurses' perception of their urgency and severity, which is underpinned by their professional experience, knowledge, training and skills. This discordance may be a cause of patient dissatisfaction. The purpose of this study is to understand the extent of agreement/disagreement between the patient's perceived priority and actual triage category and associated factors...
October 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27756354/use-of-point-of-care-testing-and-early-assessment-model-reduces-length-of-stay-for-ambulatory-patients-in-an-emergency-department
#19
Meri Kankaanpää, Maria Raitakari, Leila Muukkonen, Siv Gustafsson, Merja Heitto, Ari Palomäki, Kimmo Suojanen, Veli-Pekka Harjola
BACKGROUND: To assess whether the use of point-of-care testing (POCT) and early assessment team (EAT) model shortens emergency department (ED) length of stay (LOS). METHODS: This prospective, observational study with comparison between three study periods was performed in three phases in a metropolitan ED with 57,000 annual visits. Data were collected from adult ambulatory patients who were discharged home. Phase 1 served as a control (n = 1559 in one month)...
October 18, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27729058/unmanned-aerial-vehicles-drones-in-out-of-hospital-cardiac-arrest
#20
A Claesson, D Fredman, L Svensson, M Ringh, J Hollenberg, P Nordberg, M Rosenqvist, T Djarv, S Österberg, J Lennartsson, Y Ban
BACKGROUND: The use of an automated external defibrillator (AED) prior to EMS arrival can increase 30-day survival in out-of-hospital cardiac arrest (OHCA) significantly. Drones or unmanned aerial vehicles (UAV) can fly with high velocity and potentially transport devices such as AEDs to the site of OHCAs. The aim of this explorative study was to investigate the feasibility of a drone system in decreasing response time and delivering an AED. METHODS: Data of Global Positioning System (GPS) coordinates from historical OHCA in Stockholm County was used in a model using a Geographic Information System (GIS) to find suitable placements and visualize response times for the use of an AED equipped drone...
October 12, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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