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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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https://www.readbyqxmd.com/read/30012186/non-specific-complaints-at-emergency-department-presentation-result-in-unclear-diagnoses-and-lengthened-hospitalization-a-prospective-observational-study
#1
Thomas C Sauter, Giuliana Capaldo, Michele Hoffmann, Tanja Birrenbach, Stefanie C Hautz, Juliana E Kämmer, Aristomenis K Exadaktylos, Wolf E Hautz
BACKGROUND: Up to 20% of patients admitted to an emergency department present with non-specific complaints. Retrospective studies suggest an increased risk of misdiagnosis and hospital admission for these patients, but prospective comparisons of the outcomes of emergency patients with non-specific complaints versus specific complaints are lacking. METHODS: All consecutive patients ≥18 years of age admitted to any internal medicine ward at Bern University Hospital via the emergency department from August 15th 2015 to December 7th 2015 were prospectively included and followed up upon...
July 16, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30005711/association-between-blood-glucose-and-cardiac-rhythms-during-pre-hospital-care-of-trauma-patients-a-retrospective-analysis
#2
Janett Kreutziger, Stefan Schmid, Nikolaus Umlauf, Hanno Ulmer, Maarten W Nijsten, Daniel Werner, Thomas Schlechtriemen, Wolfgang Lederer
BACKGROUND: Deranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various cardiac rhythms and cardiac arrest following trauma. METHODS: We retrospectively investigated adult trauma patients treated by a nationwide helicopter emergency medical service (34 bases) between 2005 and 2013. All patients with recorded initial cardiac rhythms and blood glucose levels were enrolled...
July 13, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30005682/neurologic-outcome-after-out-of-hospital-cardiac-arrest-could-be-predicted-with-the-help-of-bispectral-index-during-early-targeted-temperature-management
#3
Jeong Ho Park, Jae Hun Oh, Seung Pill Choi, Jung Hee Wee
BACKGROUND: Outcome prediction is crucial for out-of-hospital cardiac arrest (OHCA) survivors. Several attempts have been made to use the bispectral index (BIS) for this purpose. We aimed to investigate the prognostic power of the BIS during the early stage of targeted temperature management (TTM) after OHCA. METHODS: From Jan 2014 to Feb 2017, the BIS was determined in OHCA patients as soon as possible after the start of TTM. We injected a neuro-muscular blocking agent and recoded the BIS value and the time when the electromyographic (EMG) factor reached zero...
July 13, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30005671/repeated-vital-sign-measurements-in-the-emergency-department-predict-patient-deterioration-within-72-hours-a-prospective-observational-study
#4
Vincent M Quinten, Matijs van Meurs, Tycho J Olgers, Judith M Vonk, Jack J M Ligtenberg, Jan C Ter Maaten
BACKGROUND: More than one in five patients presenting to the emergency department (ED) with (suspected) infection or sepsis deteriorate within 72 h from admission. Surprisingly little is known about vital signs in relation to deterioration, especially in the ED. The aim of our study was to determine whether repeated vital sign measurements in the ED can differentiate between patients who will deteriorate within 72 h and patients who will not deteriorate. METHODS: We performed a prospective observational study in patients presenting with (suspected) infection or sepsis to the ED of our tertiary care teaching hospital...
July 13, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29996880/head-to-head-comparison-of-qsofa-and-sirs-criteria-in-predicting-the-mortality-of-infected-patients-in-the-emergency-department-a-meta-analysis
#5
Jianjun Jiang, Jin Yang, Jing Mei, Yongmei Jin, Youjin Lu
BACKGROUND: Recently, the concept of sepsis was redefined by an international task force. This international task force of experts recommended using the quick Sequential Organ Failure Assessment (qSOFA) criteria instead of the systemic inflammatory response syndrome (SIRS) criteria to classify patients at high risk for death. However, the added value of these new criteria in the emergency department (ED) remains unclear. Thus, we performed this meta-analysis to determine the diagnostic accuracy of the qSOFA criteria in predicting mortality in ED patients with infections and compared the performance with that of the SIRS criteria...
July 11, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29986757/modelling-the-association-between-fibrinogen-concentration-on-admission-and-mortality-in-patients-with-massive-transfusion-after-severe-trauma-an-analysis-of-a-large-regional-database
#6
Pierre Bouzat, François-Xavier Ageron, Jonathan Charbit, Xavier Bobbia, Pauline Deras, Jennifer Bas Dit Nugues, Etienne Escudier, Guillaume Marcotte, Marc Leone, Jean-Stéphane David
BACKGROUND: The relationship between fibrinogen concentration and traumatic death has been poorly explored after severe trauma. Existing studies analysed this relationship in unselected trauma population, often considering fibrinogen concentration as a categorical variable. The aim of our study was to model the relationship between fibrinogen concentration and in-hospital mortality in severe trauma patients requiring massive transfusion using fibrinogen on admission as a continuous variable...
July 9, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29973290/identification-of-the-technical-and-medical-requirements-for-hems-avalanche-rescue-missions-through-a-15-year-retrospective-analysis-in-a-hems-in-switzerland-a-necessary-step-for-quality-improvement
#7
Alexandre Kottmann, Pierre-Nicolas Carron, Lorenz Theiler, Roland Albrecht, Mario Tissi, Mathieu Pasquier
BACKGROUND: Avalanche rescues mostly rely on helicopter emergency medical services (HEMS) and include technical rescue and complex medical situations under difficult conditions. The adequacy of avalanche victim management has been shown to be unexpectedly low, suggesting the need for quality improvement. We analyse the technical rescue and medical competency requirements of HEMS crewmembers for avalanche rescue missions, as well as their clinical exposure. The study aims to identify areas that should be the focus of future quality improvement efforts...
July 4, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29970130/acute-pain-in-the-prehospital-setting-a-register-based-study-of-41-241-patients
#8
Kristian D Friesgaard, Ingunn S Riddervold, Hans Kirkegaard, Erika F Christensen, Lone Nikolajsen
BACKGROUND: Acute pain is a frequent symptom, but little is known about the frequency and causes of acute pain in the prehospital population. The objectives of this study were to investigate the frequency of moderate to severe pain among prehospital patients and the underlying causes according to primary hospital diagnose codes. METHODS: This was a register-based study on 41.241 patients transported by ambulance. Information on moderate to severe pain [Numeric Rating Scale (NRS, 0-10) > 3 or moderate pain or higher on 4-point likert scale] was extracted from a national electronic prehospital patient record...
July 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29945644/-reality-rarely-looks-like-the-guidelines-a-qualitative-study-of-the-challenges-hospital-based-physicians-encounter-in-war-wound-management
#9
Andreas Älgå, Karin Karlow Herzog, Murad Alrawashdeh, Sidney Wong, Hamidreza Khankeh, Cecilia Stålsby Lundborg
BACKGROUND: Globally, armed conflict is a major contributor to mortality and morbidity. The treatment of war-associated injuries is largely experience-based. Evidence is weak due to difficulty in conducting medical research in war settings. A qualitative method could provide insight into the specific challenges associated with providing health care to injured civilians. The aim of this study was to explore the challenges hospital-based physicians encounter in war wound management, focusing on surgical intervention and antibiotic use...
June 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29940990/the-role-of-point-of-care-ultrasound-in-prehospital-critical-care-a-systematic-review
#10
REVIEW
Morten Thingemann Bøtker, Lars Jacobsen, Søren Steemann Rudolph, Lars Knudsen
BACKGROUND: In 2011, the role of Point of Care Ultrasound (POCUS) was defined as one of the top five research priorities in physician-provided prehospital critical care and future research topics were proposed; the feasibility of prehospital POCUS, changes in patient management induced by POCUS and education of providers. This systematic review aimed to assess these three topics by including studies examining all kinds of prehospital patients undergoing all kinds of prehospital POCUS examinations and studies examining any kind of POCUS education in prehospital critical care providers...
June 26, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29914560/predictive-factors-of-intracranial-bleeding-in-head-trauma-patients-receiving-antiplatelet-therapy-admitted-to-an-emergency-department
#11
Farès Moustafa, Jean Roubin, Bruno Pereira, Alain Barres, Jennifer Saint-Denis, Christophe Perrier, Marine Mondet, Frederic Dutheil, Jeannot Schmidt
BACKGROUND: In head trauma cases involving antiplatelet agent treatment, the French Society of Emergency Medicine recommends performing computed tomography (CT) scans to detect brain lesions, 90% of which are normal. The value of CT is still debatable given the scarce number of studies and controversial results. METHODS: We used the RATED registry (Registry of patient with Antithrombotic agents admitted to an Emergency Department, NCT02706080) to assess factors of cerebral bleeding related to antiplatelet agents following head trauma...
June 19, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29914554/prehospital-point-of-care-emergency-ultrasound-a-cohort-study
#12
Maximilian Scharonow, Christian Weilbach
BACKGROUND: In the prehospital situation, the diagnostic armamentarium available to the rescue physician is limited. Emergency ultrasound has proven to be a useful diagnostic tool, providing crucial information for the management of critically ill and injured patients. The proportion of performed ultrasound scans in all patients attended to by the rescue service team, the quality of the findings and the ultrasound-related changes in management approach and patient transport were evaluated...
June 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29880018/does-the-prehospital-national-early-warning-score-predict-the-short-term-mortality-of-unselected-emergency-patients
#13
Marko Hoikka, Tom Silfvast, Tero I Ala-Kokko
OBJECTIVES: The prehospital research field has focused on studying patient survival in cardiac arrest, as well as acute coronary syndrome, stroke, and trauma. There is little known about the overall short-term mortality and its predictability in unselected prehospital patients. This study examines whether a prehospital National Early Warning Score (NEWS) predicts 1-day and 30-day mortalities. METHODS: Data from all emergency medical service (EMS) situations were coupled to the mortality data obtained from the Causes of Death Registry during a six-month period in Northern Finland...
June 7, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29866138/capillary-and-venous-lactate-measurements-with-a-handheld-device-compared-to-venous-blood-gas-analysis-for-emergency-patients
#14
David Stoll, Erling Englund, Helene Hillborg, Stefan Vedin, Agneta Larsson
BACKGROUND/AIM: Early identification of lactate levels may have a large impact on triage classification and assist in identifying critically ill patients. A handheld device provides a rapid and timesaving measurement of lactate levels adapted to work in a prehospital care setting. I.e., the device is small, fast, and easy-to-use. The aim of this study was to evaluate the Accutrend Plus handheld lactate analyzer in comparison to the reference in-hospital method. METHODS: Patients triaged as minimum yellow according to the RETTS System (Rapid Emergency Triage and Treatment System) and transported to hospital by ambulance were selected and a written consent to participate was obtained prior to inclusion in the study...
June 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29866144/standardised-data-reporting-from-pre-hospital-advanced-airway-management-a-nominal-group-technique-update-of-the-utstein-style-airway-template
#15
G A Sunde, A Kottmann, J K Heltne, M Sandberg, M Gellerfors, A Krüger, D Lockey, S J M Sollid
BACKGROUND: Pre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients. To improve pre-hospital critical care and develop evidence-based guidelines, research on standardised high-quality data is important. We aimed to identify which airway data were most important to report today and to revise and update a previously reported Utstein-style airway management dataset. METHODS: We recruited sixteen international experts in pre-hospital airway management from Australia, United States of America, and Europe...
June 4, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29859121/critcomms-a-national-cross-sectional-questionnaire-based-study-to-investigate-prehospital-handover-practices-between-ambulance-clinicians-and-specialist-prehospital-teams-in-scotland
#16
David Fitzpatrick, Michael McKenna, Edward A S Duncan, Colville Laird, Richard Lyon, Alasdair Corfield
BACKGROUND: Poor communication during patient handover is recognised internationally as a root cause of a significant proportion of preventable deaths. Improving the accuracy and quality of handover may reduce associated mortality and morbidity. Although the practice of handover between Ambulance and Emergency Department clinicians has received some attention over recent years there is little evidence to support handover best practice within the prehospital domain. Further research is therefore urgently required to understand the most appropriate way to deliver clinical information exchange in the pre-hospital environment...
June 1, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29859111/quality-of-life-and-level-of-post-traumatic-stress-disorder-among-trauma-patients-a-comparative-study-between-a-regional-and-a-university-hospital
#17
F B Danielsson, M Schultz Larsen, B Nørgaard, J M Lauritsen
BACKGROUND: The aim of this study was to assess outcome in long-term quality of life (QoL) and post-traumatic stress disorder (PTSD) among adult survivors of trauma. Secondary aim was to compare levels of the outcome with injury severity and specialization level of two trauma centres. METHODS: A retrospective study included patients received by the trauma response teams at two hospitals in 2013 aged 18 or more at follow-up. We assessed QoL and PTSD with one mailed questionnaire to each patient at either 12 or 24 months of follow-up...
June 1, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29855384/electrical-injury-a-dual-center-analysis-of-patient-characteristics-therapeutic-specifics-and-outcome-predictors
#18
Jochen Gille, Thomas Schmidt, Adrian Dragu, Dimitri Emich, Peter Hilbert-Carius, Thomas Kremer, Thomas Raff, Beate Reichelt, Apostolos Siafliakis, Frank Siemers, Michael Steen, Manuel F Struck
BACKGROUND: Electrical injuries represent life-threatening emergencies. Evidence on differences between high (HVI) and low voltage injuries (LVI) regarding characteristics at presentation, rhabdomyolysis markers, surgical and intensive burn care and outcomes is scarce. METHODS: Consecutive patients admitted to two burn centers for electrical injuries over an 18-year period (1998-2015) were evaluated. Analysis included comparisons of HVI vs. LVI regarding demographic data, diagnostic and treatment specific variables, particularly serum creatinine kinase (CK) and myoglobin levels over the course of 4 post injury days (PID), and outcomes...
May 31, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29793526/comparing-population-and-incident-data-for-optimal-air-ambulance-base-locations-in-norway
#19
Jo Røislien, Pieter L van den Berg, Thomas Lindner, Erik Zakariassen, Oddvar Uleberg, Karen Aardal, J Theresia van Essen
BACKGROUND: Helicopter emergency medical services are important in many health care systems. Norway has a nationwide physician manned air ambulance service servicing a country with large geographical variations in population density and incident frequencies. The aim of the study was to compare optimal air ambulance base locations using both population and incident data. METHODS: We used municipality population and incident data for Norway from 2015. The 428 municipalities had a median (5-95 percentile) of 4675 (940-36,264) inhabitants and 10 (2-38) incidents...
May 24, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29764468/development-and-implementation-of-a-geographical-area-categorisation-method-with-targeted-performance-indicators-for-nationwide-ems-in-finland
#20
Jukka Pappinen, Päivi Laukkanen-Nevala, Pekka Mäntyselkä, Jouni Kurola
BACKGROUND: In Finland, hospital districts (HD) are required by law to determine the level and availability of Emergency Medical Services (EMS) for each 1-km2 sized area (cell) within their administrative area. The cells are currently categorised into five risk categories based on the predicted number of missions. Methodological defects and insufficient instructions have led to incomparability between EMS services. The aim of this study was to describe a new, nationwide method for categorising the cells, analyse EMS response time data and describe possible differences in mission profiles between the new risk category areas...
May 15, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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