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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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https://www.readbyqxmd.com/read/29321074/patient-and-case-characteristics-associated-with-no-paramedic-treatment-for-low-acuity-cases-referred-for-emergency-ambulance-dispatch-following-a-secondary-telephone-triage-a-retrospective-cohort-study
#1
Kathryn Eastwood, Amee Morgans, Johannes Stoelwinder, Karen Smith
BACKGROUND: Predicting case types that are unlikely to be treated by paramedics can aid in managing demand for emergency ambulances by identifying cases suitable for alternative management pathways. The aim of this study was to identify the patient characteristics and triage outcomes associated with 'no paramedic treatment' for cases referred for emergency ambulance dispatch following secondary telephone triage. METHODS: A retrospective cohort analysis was conducted of cases referred for emergency ambulance dispatch following secondary telephone triage between September 2009 and June 2012...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29321048/danish-first-aid-books-compliance-with-the-new-evidence-based-non-resuscitative-first-aid-guidelines
#2
Theo Walther Jensen, Thea Palsgaard Møller, Søren Viereck, Jens Roland, Thomas Egesborg Pedersen, Freddy K Lippert
BACKGROUND: The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current major Danish national first aid books to identify potential inconsistencies between the current books and the new evidence-based first aid guidelines. METHODS: We identified first aid books from all the first aid courses offered by major Danish suppliers...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29310701/severe-thoracic-trauma-still-an-independent-predictor-for-death-in-multiple-injured-patients
#3
Michael Grubmüller, Maximilian Kerschbaum, Eva Diepold, Katharina Angerpointner, Michael Nerlich, Antonio Ernstberger
BACKGROUND: Over the past, the severe thoracic trauma has had decisive influence on the outcome of multiple injured patients. Today, new therapies (e.g. extracorporeal membrane oxygenation (ECMO), protective ventilation methods and new forms of patient positioning) are available and applied regularly. What impact on the patient's outcome does the thoracic trauma have today? METHODS: Prospective data collection of multiple injured patients in a level-I trauma center was performed between 2008 and 2014...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29310687/long-term-mortality-of-acetaminophen-poisoning-a-nationwide-population-based-cohort-study-with-10-year-follow-up-in-taiwan
#4
Hung-Sheng Huang, Chung-Han Ho, Shih-Feng Weng, Chien-Chin Hsu, Jhi-Joung Wang, Shih-Bin Su, Hung-Jung Lin, Chien-Cheng Huang
BACKGROUND: The long-term mortality of acetaminophen (APAP) poisoning has not yet been well studied; hence, we conducted this study to gain understanding of this issue. METHODS: We conducted a nationwide population-based cohort study by identifying 3235 participants with APAP poisoning and 9705 participants without APAP poisoning in Taiwan between 2003 and 2012 in the Nationwide Poisoning Database and Longitudinal Health Insurance Database 2000. Participants with APAP poisoning and control subjects were compared for the risk of all-cause mortality by follow-up until 2013...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29310686/comparison-of-two-different-coagulation-algorithms-on-the-use-of-allogenic-blood-products-and-coagulation-factors-in-severely-injured-trauma-patients-a-retrospective-multicentre-observational-study
#5
Alexander Kaserer, Mattias Casutt, Kai Sprengel, Burkhardt Seifert, Donat R Spahn, Philipp Stein
BACKGROUND: At the University Hospital Zurich (USZ) and the Cantonal Hospital of Lucerne (LUKS) an individualized goal-directed coagulation and transfusion algorithm was introduced and implemented before 2012 (Coagulation algorithm of the USZ: USZ-Alg; of the LUKS: LUKS-Alg). Main differences between both algorithms are: 1) A target haematocrit-range of 0.21-0.24 (USZ-Alg) vs. a lower haematocrit limit only (LUKS-Alg). 2) Blind coagulation-package in selected cases (LUKS-Alg only). 3) Factor XIII substitution is considered earlier according to the USZ-Alg...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29304855/prognostic-value-of-coagulation-tests-for-in-hospital-mortality-in-patients-with-traumatic-brain-injury
#6
Qiang Yuan, Jian Yu, Xing Wu, Yi-Rui Sun, Zhi-Qi Li, Zhuo-Ying Du, Xue-Hai Wu, Jin Hu
BACKGROUND: Coagulopathy is commonly observed after traumatic brain injury (TBI). However, it is not known whether using the standard independent predictors in conjunction with coagulation tests would improve their prognostic value. We determined the incidence of TBI-associated coagulopathy in patients with isolated TBI (iTBI), evaluated the prognostic value of coagulation tests for in-hospital mortality, and tested their predictive power for in-hospital mortality in patients with iTBI...
January 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29304841/paediatric-medical-emergency-calls-to-a-danish-emergency-medical-dispatch-centre-a-retrospective-observational-study
#7
Kasper Andersen, Søren Mikkelsen, Gitte Jørgensen, Stine Thorhauge Zwisler
BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years...
January 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29298710/emergency-medicine-for-25%C3%A2-years-in-iceland-history-of-the-specialty-in-a-nutshell
#8
Jón Baldursson, Hjalti Már Björnsson, Ari Palomäki
After the early implementation of Emergency Medicine (EM) 25 years ago, Iceland became the first Nordic country to nationally realize the benefits of this specialty. However, the road has been rocky as in many other countries. The early years of EM in Iceland were characterized by a significant shortage of resources, particularly a lack of medical staff dedicated to EM and properly trained for the services required. The main task for the first couple of decades was to build the infrastructure of an operational emergency department based primarily on the model of EM...
January 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29284542/a-comparison-of-two-emergency-medical-dispatch-protocols-with-respect-to-accuracy
#9
Klara Torlén, Lisa Kurland, Maaret Castrén, Knut Olanders, Katarina Bohm
BACKGROUND: Emergency medical dispatching should be as accurate as possible in order to ensure patient safety and optimize the use of ambulance resources. This study aimed to compare the accuracy, measured as priority level, between two Swedish dispatch protocols - the three-graded priority protocol Medical Index and a newly developed prototype, the four-graded priority protocol, RETTS-A. METHODS: A simulation study was carried out at the Emergency Medical Communication Centre (EMCC) in Stockholm, Sweden, between October and March 2016...
December 29, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29262853/proper-training-and-use-of-ultrasonography-facilitates-lumbar-puncture
#10
LETTER
Geert-Jan van Geffen, Rein Ketelaars, Jörgen Bruhn
With great interest, we read the study of Line Dussourd et al. concluding that ultrasonography allows better identification of anatomical structures before performing a lumbar puncture. We cannot concur with the conclusions of the study because the authors did not visualize the conus medullaris directly, nor did they assess the individual intervertebral levels. In our commentary, we make some suggestions for improvement using ultrasound to locate the optimal site for a lumbar puncture. We do agree that neuraxial ultrasound is of great benefit for the performance of lumbar punctures...
December 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29262829/therapeutic-hypothermia-in-patients-with-coagulopathy-following-severe-traumatic-brain-injury
#11
Toru Hifumi, Yasuhiro Kuroda, Kenya Kawakita, Susumu Yamashita, Yasutaka Oda, Kenji Dohi, Tsuyoshi Maekawa
BACKGROUND: Coagulopathy in traumatic brain injury (TBI) has been associated with poor neurological outcomes and higher in-hospital mortality. In general principle of trauma management, hypothermia should be prevented as it directly worsens coagulopathy. Therefore, we examined the safety of mild therapeutic hypothermia (MTH) in patients with coagulopathy following severe TBI. METHODS: We re-evaluated the brain hypothermia (B-HYPO) study data based on coagulopathy and compared the Glasgow Outcome Scale scores and survival rates at 6 months using per protocol analyses...
December 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29208018/noise-exposure-during-prehospital-emergency-physicians-work-on-mobile-emergency-care-units-and-helicopter-emergency-medical-services
#12
Mads Christian Tofte Hansen, Jesper Hvass Schmidt, Anne C Brøchner, Jakob Kjersgaard Johansen, Stine Zwisler, Søren Mikkelsen
BACKGROUND: Prehospital personnel are at risk of occupational hearing loss due to high noise exposure. The aim of the study was to establish an overview of noise exposure during emergency responses in Mobile Emergency Care Units (MECU), ambulances and Helicopter Emergency Medical Services (HEMS). A second objective was to identify any occupational hearing loss amongst prehospital personnel. METHODS: Noise exposure during work in the MECU and HEMS was measured using miniature microphones worn laterally to the auditory canals or within the earmuffs of the helmet...
December 6, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29202774/pre-hospital-advanced-airway-management-in-children-a-challenge-that-training-can-handle
#13
LETTER
Joanna B Watterson, Cliff Reid, Brian J Burns, Luke Regan
We respond to the Tarpgaard et al. article reporting on pre-hospital endotracheal intubation (PHETI) success and complications by Danish critical care teams including critical care anaesthetists. We compare the authors' results with previously published results from our service's experience with PHETI in a similar patient population, also with physician and paramedic medical teams. From 25 children <16 years of age, the Danish study reports overall success, and first-pass success, and complication rates of 96, 75 and 20%, respectively...
December 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29202769/impact-of-systolic-blood-pressure-limits-on-the-diagnostic-value-of-triage-algorithms
#14
Tobias Neidel, Nicolas Salvador, Axel R Heller
BACKGROUND: Major incidents are characterized by a lack of resources compared to an overwhelming number of casualties, requiring a prioritization of medical treatment. Triage algorithms are an essential tool for prioritizing the urgency of treatment for patients, but the evidence to support one over another is very limited. We determined the influence of blood pressure limits on the diagnostic value of triage algorithms, considering if pulse should be palpated centrally or peripherally...
December 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29183366/the-effect-on-the-patient-flow-in-local-health-care-services-after-closing-a-suburban-primary-care-emergency-department-a-controlled-longitudinal-follow-up-study
#15
Katri Mustonen, Jarmo Kantonen, Timo Kauppila
BACKGROUND: It has not been studied what happens to patient flow to EDs and other parts of local health care system if distances to ED services are manipulated as a part of health policy in urban areas. METHODS: The present work was an observational and quasi-experimental study with a control and it was based on before-after comparisons. The impact of terminating a geographically distant suburban primary care ED on patient flow to doctors in local public primary care EDs, office-hour primary care, secondary care EDs and in private primary care was studied...
November 28, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29179764/routine-blood-tests-are-associated-with-short-term-mortality-and-can-improve-emergency-department-triage-a-cohort-study-of-12-000-patients
#16
Michael Kristensen, Anne Kristine Servais Iversen, Thomas Alexander Gerds, Rebecca Østervig, Jakob Danker Linnet, Charlotte Barfod, Kai Henrik Wiborg Lange, György Sölétormos, Jakob Lundager Forberg, Jesper Eugen-Olsen, Lars Simon Rasmussen, Morten Schou, Lars Køber, Kasper Iversen
BACKGROUND: Prioritization of acutely ill patients in the Emergency Department remains a challenge. We aimed to evaluate whether routine blood tests can predict mortality in unselected patients in an emergency department and to compare risk prediction with a formalized triage algorithm. METHODS: A prospective observational cohort study of 12,661 consecutive admissions to the Emergency Department of Nordsjælland University Hospital during two separate periods in 2010 (primary cohort, n = 6279) and 2013 (validation cohort, n = 6383)...
November 28, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29178941/s100a8-a9-and-srage-kinetic-after-polytrauma-an-explorative-observational-study
#17
Philippe Joly, John C Marshall, Philippe A Tessier, Chantal Massé, Nathalie Page, Anne Julie Frenette, François Khazoom, Soazig Le Guillan, Yves Berthiaume, Emmanuel Charbonney
BACKGROUND: Following tissue injury after trauma, the activation of innate immune pathways results in systemic inflammation, organ failure and an increased risk of infections. The objective of this study was to characterize the kinetics of the S100A8/S100A9 complex, a new-recognized alarmin, as well as its soluble receptor sRAGE, over time after trauma as potential early biomarkers of the risk of organ damage. METHODS: We collected comprehensive data from consenting patients admitted to an ICU following severe trauma...
November 25, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29178926/letter-to-the-editor-regarding-the-article-identifying-pre-hospital-factors-associated-with-outcome-for-major-trauma-patients-in-a-regional-trauma-network-an-exploratory-study
#18
LETTER
Charlie A Sewalt, Eveline J A Wiegers, Esmee Venema, Hester F Lingsma
The aim of this Letter to the Editor was to report some methodological shortcomings in a recently published article. Issues regarding missing values and overfitting are mentioned. First, Complete Case (CC) analysis was used instead of an imputation method. Second, there was a high chance of overfitting and lack of model validation. In conclusion, the results of this study should be interpret with caution and further research is necessary.
November 25, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29169401/treatment-of-splenic-trauma-in-norway-a-retrospective-cohort-study
#19
Trond Dehli, Jorunn Skattum, Bjørn Christensen, Ole-Petter Vinjevoll, Bent-Åge Rolandsen, Christine Gaarder, Pål Aksel Næss, Torben Wisborg
BACKGROUND: Non-operative management of splenic injuries has become the treatment of choice in hemodynamically stable patients over the last decades. The aim of the study is to describe the incidence, initial treatment and early outcome of patients with splenic injuries on a national level. METHODS: All hospitals in Norway admitting trauma patients were invited to participate in the study. The study period was January through December 2013. The hospitals delivered anonymous data on primarily admitted patients with splenic injury...
November 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29166938/a-case-of-blunt-thoracic-aortic-injury-requiring-ecmo-for-acute-malperfusion-before-tevar
#20
Daiki Wada, Koichi Hayakawa, Shuji Kanayama, Shuhei Maruyama, Hiromu Iwamura, Noriyuki Miyama, Fukuki Saito, Yasushi Nakamori, Yasuyuki Kuwagata
BACKGROUND: Blunt thoracic aortic injury (BTAI) is associated with a high mortality rate and the paradigm of treating patients with BTAI currently favours thoracic endovascular aneurysm repair (TEVAR) if possible. In BTAI, lethal malperfusion caused by a pseudoaneurysm has rarely been reported. We present the first report of a successful case in which a pseudoaneurysm causing the infrequent occurrence of lethal malperfusion and subsequent acute severe ischaemia in the distal portion of the thoracic descending aorta was overcome by veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a bridging therapy until the initiation of TEVAR...
November 22, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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