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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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https://www.readbyqxmd.com/read/29764468/development-and-implementation-of-a-geographical-area-categorisation-method-with-targeted-performance-indicators-for-nationwide-ems-in-finland
#1
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
https://www.readbyqxmd.com/read/29764455/nerve-trauma-of-the-lower-extremity-evaluation-of-60-422-leg-injured-patients-from-the-traumaregister-dgu%C3%A2-between-2002-and-2015
#2
Torge Huckhagel, Jakob Nüchtern, Jan Regelsberger, Mathias Gelderblom, Rolf Lefering
BACKGROUND: Nerve lesions are well known reasons for reduced functional capacity and diminished quality of life. By now only a few epidemiological studies focus on lower extremity trauma related nerve injuries. This study reveals frequency and characteristics of nerve damages in patients with leg trauma in the European context. METHODS: Sixty thousand four hundred twenty-two significant limb trauma cases were derived from the TraumaRegister DGU® between 2002 and 2015...
May 15, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29751816/ventilation-of-intubated-patients-during-hems-hoisting-operations
#3
LETTER
John Hollott
In response to the review "Advanced airway management in hoist and longline operations in mountain HEMS - considerations in austere environments: a narrative review." by Pietsch et al. we refer to recently published original research describing manual versus automatic ventilation of intubated patients during helicopter hoisting operations.
May 11, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29739432/emergency-management-of-patients-with-st-segment-elevation-myocardial-infarction-in-eastern-austria-a-descriptive-quality-control-study
#4
Helmut Trimmel, Thomas Bayer, Wolfgang Schreiber, Wolfgang G Voelckel, Lukas Fiedler
BACKGROUND: Myocardial infarction is a time-critical condition and its outcome is determined by appropriate emergency care. Thus we assessed the efficacy of a supra-regional ST-segment elevation myocardial infarction (STEMI) network in Easternern Austria. METHODS: The Eastern Austrian STEMI network serves a population of approx. 766.000 inhabitants within a region of 4186 km2 . Established in 2007, it now comprises 20 pre-hospital emergency medical service (EMS) units (10 of these physician-staffed), 4 hospitals and 3 cardiac intervention centres...
May 9, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29724238/apples-to-apples-can-differences-in-out-of-hospital-cardiac-arrest-incidence-and-outcomes-between-sweden-and-ireland-be-explained-by-core-utstein-variables
#5
Siobhán Masterson, Anneli Strömsöe, John Cullinan, Conor Deasy, Akke Vellinga
BACKGROUND: Variation in reported incidence and outcome based on aggregated data is a persistent feature of out-of-hospital cardiac arrest (OHCA) epidemiology. OBJECTIVE: To investigate the extent to which patient-level analysis using core 'Utstein' variables explains inter-country variation between Sweden and the Republic of Ireland. METHODS: A retrospective cross-sectional comparative study was performed, including all Swedish and Irish OHCA cases attended by Emergency Medical Services (EMS-attended OHCA) where resuscitation was attempted from 1st January 2012 to 31st December 2014...
May 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29704898/implementation-of-a-mechanical-cpr-device-in-a-physician-staffed-hems-a-prospective-observational-study
#6
LETTER
Simon Rauch, Giacomo Strapazzon, Monika Brodmann, Ernst Fop, Christian Masoner, Lydia Rauch, Alessandro Forti, Urs Pietsch, Peter Mair, Hermann Brugger
In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device (LUCAS 2; Physio Control, Redmond, WA, USA) in a physician staffed helicopter emergency medical service (HEMS) in South Tyrol, Italy. During the study period (06/2013-04/2016), 525 OHCA cases were registered by the dispatch centre, 271 (51.6%) were assisted by HEMS. LUCAS 2 was applied in 18 (6.6%) of all HEMS-assisted OHCA patients; ten were treated with LUCAS 2 at the scene only, and eight were transported to hospital with ongoing CPR...
April 28, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29703240/temporal-phenotyping-of-circulating-microparticles-after-trauma-a-prospective-cohort-study
#7
Matthias Fröhlich, Nadine Schäfer, Michael Caspers, Julia K Böhm, Ewa K Stürmer, Bertil Bouillon, Marc Maegele
BACKGROUND: After severe polytrauma the dynamic process of coagulation may deteriorate towards a trauma-induced coagulopathy (TIC) promoting a dramatic increase in morbidity and mortality. Recent evidence suggests that microparticles (MPs) play a pivotal role at the interface between cellular and plasmatic coagulation systems. However, the impact of MPs on functional coagulation has not been clarified yet in the setting of traumatic injuries. We assessed the temporal patterns of circulating MP concentrations including their cellular origin in the context of clinical presentation and global coagulation assays...
April 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29703222/the-epidemiology-of-mild-traumatic-brain-injury-the-trondheim-mtbi-follow-up-study
#8
Toril Skandsen, Cathrine Elisabeth Einarsen, Ingunn Normann, Stine Bjøralt, Rune Hatlestad Karlsen, David McDonagh, Tom Lund Nilsen, Andreas Nylenna Akslen, Asta Kristine Håberg, Anne Vik
BACKGROUND: Mild traumatic brain injury (MTBI) is a frequent medical condition, and some patients report long-lasting problems after MTBI. In order to prevent MTBI, knowledge of the epidemiology is important and potential bias in studies should be explored. Aims of this study were to describe the epidemiological characteristics of MTBI in a Norwegian area and to evaluate the representativeness of patients successfully enrolled in the Trondheim MTBI follow-up study. METHODS: During 81 weeks in 2014 and 2015, all persons aged 16-60 years, presenting with possible MTBI to the emergency department (ED) at St...
April 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29703219/primary-mass-casualty-incident-triage-evidence-for-the-benefit-of-yearly-brief-re-training-from-a-simulation-study
#9
Michael S Dittmar, Philipp Wolf, Marc Bigalke, Bernhard M Graf, Torsten Birkholz
BACKGROUND: Triage is a mainstay of early mass casualty incident (MCI) management. Standardized triage protocols aim at providing valid and reproducible results and, thus, improve triage quality. To date, there is little data supporting the extent and content of training and re-training on using such triage protocols within the Emergency Medical Services (EMS). The study objective was to assess the decline in triage skills indicating a minimum time interval for re-training. In addition, the effect of a one-hour repeating lesson on triage quality was analyzed...
April 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29690930/simple-modification-of-trauma-mechanism-alarm-criteria-published-for-the-traumanetwork-dgu-%C3%A2-may-significantly-improve-overtriage-a-cross-sectional-study
#10
Philipp Braken, Felix Amsler, Thomas Gross
BACKGROUND: No consensus exists in the literature on the use of uniform emergency room trauma team activation criteria (ERTTAC). Today excessive over- or undertriage rates continue to be a challenge for most trauma centres. Application of ERTTAC, published for use in the German TraumaNetwork DGU® , at a Swiss trauma centre resulted in a high overtriage rate. The aim of the investigation was to analyse the ERTTAC in detail with the intention of possible improvement. METHODS: The investigation included consecutive adult (age > 15 years) trauma patients treated at the emergency department of a level II trauma centre from 01...
April 24, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29690910/haemodynamic-outcomes-during-piston-based-mechanical-cpr-with-or-without-active-decompression-in-a-porcine-model-of-cardiac-arrest
#11
Mikkel T Steinberg, Jan-Aage Olsen, Morten Eriksen, Andres Neset, Per Andreas Norseng, Jo Kramer-Johansen, Bjarne Madsen Hardig, Lars Wik
BACKGROUND: Experimental active compression-decompression (ACD) CPR is associated with increased haemodynamic outcomes compared to standard mechanical chest compressions. Since no clinically available mechanical chest compression device is capable of ACD-CPR, we modified the LUCAS 2 (Physio-Control, Lund, Sweden) to deliver ACD-CPR, hypothesising it would improve haemodynamic outcomes compared with standard LUCAS CPR on pigs with cardiac arrest. METHODS: The modified LUCAS delivering 5 cm compressions with or without 2 cm active decompression above anatomical chest level was studied in a randomized crossover design on 19 Norwegian domestic pigs...
April 24, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29685180/traumatic-cardiac-arrest-in-sweden-1990-2016-a-population-based-national-cohort-study
#12
T Djarv, C Axelsson, J Herlitz, A Stromsoe, J Israelsson, A Claesson
BACKGROUND: Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to describe characteristics and 30-day survival following a TCA as compared with a medical out-of-hospital cardiac arrest (medical CA). METHODS: A cohort study based on data from the nationwide, prospective population-based Swedish Registry for Cardiopulmonary Resuscitation (SRCR), a medical cardiac arrest registry, between 1990 and 2016...
April 23, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29678207/risk-factors-associated-with-short-term-mortality-changes-over-time-after-arrival-to-the-emergency-department
#13
Camilla Nørgaard Bech, Mikkel Brabrand, Søren Mikkelsen, Annmarie Lassen
BACKGROUND: Preventing death is the most important outcome pursued in the Emergency Department. Prompt accurate assessment, followed by competent and efficient investigation and treatment is the recipe sought. Abnormal physiological measurements are common antecedents to deterioration and therefore a cornerstone in many risk stratification tools. Some risk factors have their impact during the first few days after admittance, others have higher impact on 30 day mortality. Understanding the variance in impact of risk factors is relevant for future composition of risk stratification models...
April 20, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29669572/one-year-and-three-year-mortality-prediction-in-adult-major-blunt-trauma-survivors-a-national-retrospective-cohort-analysis
#14
Ting Hway Wong, Nivedita Vikas Nadkarni, Hai V Nguyen, Gek Hsiang Lim, David Bruce Matchar, Dennis Chuen Chai Seow, Nicolas K K King, Marcus Eng Hock Ong
BACKGROUND: Survivors of trauma are at increased risk of dying after discharge. Studies have found that age, head injury, injury severity, falls and co-morbidities predict long-term mortality. The objective of our study was to build a nomogram predictor of 1-year and 3-year mortality for major blunt trauma adult survivors of the index hospitalization. METHODS: Using data from the Singapore National Trauma Registry, 2011-2013, we analyzed adults aged 18 and over, admitted after blunt injury, with an injury severity score (ISS) of 12 or more, who survived the index hospitalization, linked to death registry data...
April 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29622032/change-in-the-profile-of-traumatic-spinal-cord-injury-over-15-years-in-spain
#15
Enrique Bárbara-Bataller, José Luis Méndez-Suárez, Carolina Alemán-Sánchez, Jesús Sánchez-Enríquez, Manuel Sosa-Henríquez
BACKGROUND: Traumatic spinal cord injury remains a serious public health and social problem. Although incidence rates are decreasing in our environment, it is a high cost condition that is associated with great disability. The objective of this study was to describe the epidemiological and demographic characteristics of traumatic spinal cord injury and to analyse its epidemiological changes. METHODS: This study was an observational study with prospective monitoring of all traumatic spinal cord injury patients in the Canary Islands, Spain (2...
April 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29622029/admission-rates-in-a-general-practitioner-based-versus-a-hospital-specialist-based-hospital-at-home-model-access-an-open-labelled-randomised-clinical-trial-of-effectiveness
#16
Christian Backer Mogensen, Ejnar Skytte Ankersen, Mats J Lindberg, Stig L Hansen, Jørgen Solgaard, Pia Therkildsen, Helene Skjøt-Arkil
BACKGROUND: Hospital at home (HaH) is an alternative to acute admission for elderly patients. It is unclear if should be cared for a primarily by a hospital intern specialist or by the patient's own general practitioner (GP). The study assessed whether a GP based model was more effective than a hospital specialist based model at reducing number of hospital admissions without affecting the patient's recovery or number of deaths. METHODS: Pragmatic, randomised, open-labelled multicentre parallel group trial with two arms in four municipalities, four emergency departments and 150 GPs in Southern Denmark, including + 65 years old patients with an acute medical condition that required acute hospital in-patient care...
April 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29618372/prehospital-triage-of-patients-diagnosed-with-perforated-peptic-ulcer-or-peptic-ulcer-bleeding-an-observational-study-of-patients-calling-1-1-2
#17
Kasper Bonnesen, Kristian D Friesgaard, Morten T Boetker, Lone Nikolajsen
BACKGROUND: Triage systems are used in emergency medical services to systematically prioritize prehospital resources according to individual patient conditions. Previous studies have shown cases of preventable deaths in emergency medical services even when triage systems are used, indicating a potential undertriage among some conditions. The aim of this study was to investigate the triage level among patients diagnosed with perforated peptic ulcer (PPU) or peptic ulcer bleeding (PUB)...
April 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29615089/decreased-risk-adjusted-30-day-mortality-for-hospital-admitted-injuries-a-multi-centre-longitudinal-study
#18
Robert Larsen, Denise Bäckström, Mats Fredrikson, Ingrid Steinvall, Rolf Gedeborg, Folke Sjoberg
BACKGROUND: The interpretation of changes in injury-related mortality over time requires an understanding of changes in the incidence of the various types of injury, and adjustment for their severity. Our aim was to investigate changes over time in incidence of hospital admission for injuries caused by falls, traffic incidents, or assaults, and to assess the risk-adjusted short-term mortality for these patients. METHODS: All patients admitted to hospital with injuries caused by falls, traffic incidents, or assaults during the years 2001-11 in Sweden were identified from the nationwide population-based Patient Registry...
April 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29615073/advanced-airway-management-in-hoist-and-longline-operations-in-mountain-hems-considerations-in-austere-environments-a-narrative-review-this-review-is-endorsed-by-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#19
REVIEW
Urs Pietsch, Jürgen Knapp, Oliver Kreuzer, Ludwig Ney, Giacomo Strapazzon, Volker Lischke, Roland Albrecht, Patrick Phillips, Simon Rauch
BACKGROUND: Providing sufficient oxygenation and ventilation is of paramount importance for the survival of emergency patients. Therefore, advanced airway management is one of the core tasks for every rescue team. Endotracheal intubation is the gold standard to secure the airway in the prehospital setting. This review aims to highlight special considerations for advanced airway management preceding human external cargo (HEC) evacuations. METHODS: We systematically searched MEDLINE, EMBASE, and PubMed in August 2017 for articles on airway management and ventilation in patients before hoist or longline operation in HEMS...
April 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29587862/trauma-facilities-in-denmark-a-nationwide-cross-sectional-benchmark-study-of-facilities-and-trauma-care-organisation
#20
Jesper Weile, Klaus Nielsen, Stine C Primdahl, Christian A Frederiksen, Christian B Laursen, Erik Sloth, Ole Mølgaard, Lars Knudsen, Hans Kirkegaard
BACKGROUND: Trauma is a leading cause of death among adults aged < 44 years, and optimal care is a challenge. Evidence supports the centralization of trauma facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management...
March 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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