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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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https://www.readbyqxmd.com/read/30241559/impact-of-drug-and-equipment-preparation-on-pre-hospital-emergency-anaesthesia-phea-procedural-time-error-rate-and-cognitive-load
#1
Paul Swinton, Alasdair R Corfield, Chris Moultrie, David Percival, Jeffrey Proctor, Neil Sinclair, Zane B Perkins
BACKGROUND: We examined the effect of advanced preparation and organisation of equipment and drugs for Pre-hospital Emergency Anaesthesia (PHEA) and tracheal intubation on procedural time, error rates, and cognitive load. METHODS: This study was a randomised, controlled experiment with a crossover design. Clinical teams (physician and paramedic) from the Emergency Medical Retrieval Service and the Scottish Air Ambulance Division were randomised to perform a standardised pre-hospital clinical simulation using either unprepared (standard practice) or pre-prepared (experimental method) PHEA equipment and drugs...
September 21, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30241544/a-socio-economic-analysis-of-increased-staffing-in-the-norwegian-helicopter-emergency-medical-service
#2
Eirik Bjorheim Abrahamsen, Jon Tømmerås Selvik, Anders Nordgaard Dahle, Frank Asche, Håkon Bjorheim Abrahamsen
BACKGROUND: The European Aviation Safety Agency (EASA) is preparing a new set of regulations that will cover working and resting periods for crew members engaged in emergency medical services with helicopters (HEMS) and aeroplanes (AEMS). Such a shared European regulatory framework has already been introduced for the majority of commercial operations with aeroplanes, whereas national regulations are still in place for helicopter operations. A possible consequence of changing the regulations on working and resting periods for helicopter operations is that current abilities to provide 24-h, continuous emergency readiness with the same helicopter crew will be changed to a daily shift pattern with two, and even up to three, different crews to cover one 24-h period...
September 21, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30236125/independent-determinants-of-prolonged-emergency-department-length-of-stay-in-a-tertiary-care-centre-a-prospective-cohort-study
#3
Daniël van der Veen, Claudia Remeijer, Anne J Fogteloo, Christian Heringhaus, Bas de Groot
BACKGROUND: Emergency department (ED) overcrowding is a potential threat for patient safety. We searched for independent determinants of prolonged ED length of stay (LOS) with the aim to identify factors which can be targeted to reduce ED LOS, which may help in preventing overcrowding. METHODS: This prospective cohort study included consecutive ED patients in a Dutch tertiary care centre. Multivariable logistic regression analysis was used to identify independent determinants of ED LOS > 4 h, including patient characteristics (demographics, referral type, acuity, (number of) presenting complaints and comorbidity), treating specialty, diagnostic testing, consultations, number of patients in the ED and disposition...
September 20, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30223859/first-establishment-of-a-new-table-rotated-type-hybrid-emergency-room-system
#4
Hiroaki Watanabe, Yoshihide Shimojo, Eiji Hira, Shunsuke Kuramoto, Tomohiro Muronoi, Kazuyuki Oka, Akihiko Kidani
The hybrid emergency room (hybrid ER) system was first established in 2011 in Japan. It is defined as an integrated system including an ER, emergency computed tomography (CT) and interventional radiology (IVR) rooms, and operating rooms. Severe trauma patients can undergo emergency CT examinations and therapies (surgeries) without being transferred. The hybrid ER system is attracting attention because trauma resuscitation using this system has been reported to potentially improve the mortality rate in severe trauma patients...
September 17, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30217231/safety-of-on-scene-medical-care-by-ems-nurses-in-non-transported-patients-a-prospective-observational-study
#5
Wim Breeman, Nathan A Poublon, Michael H J Verhofstad, Esther M M Van Lieshout
BACKGROUND: After on-scene examination and /or treatment, emergency medical services (EMS) nurses must decide whether the patient requires further assessment or treatment, most frequently in a hospital. The primary objective of this study was to assess the reliability of the current EMS protocol by determining whether the decision not to transport the patient to a care provider was correct or not. METHODS: Adults receiving on-scene medical care by an EMS rapid responder or full team without transport to the hospital were included in this prospective observational study...
September 14, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30201025/nerve-injury-in-severe-trauma-with-upper-extremity-involvement-evaluation-of-49-382-patients-from-the-traumaregister-dgu%C3%A2-between-2002-and-2015
#6
Torge Huckhagel, Jakob Nüchtern, Jan Regelsberger, Rolf Lefering
BACKGROUND: Peripheral nerve injury (PNI) as an adjunct lesion in patients with upper extremity trauma has not been investigated in a Central European setting so far, despite of its devastating long-term consequences. This study evaluates a large multinational trauma registry for prevalence, mechanisms, injury severity and outcome characteristics of upper limb nerve lesions. METHODS: After formal approval the TraumaRegister DGU® (TR-DGU) was searched for severely injured cases with upper extremity involvement between 2002 and 2015...
September 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30201018/how-does-the-length-of-cardiopulmonary-resuscitation-affect-brain-damage-in-patients-surviving-cardiac-arrest-a-systematic-review
#7
REVIEW
Clare Welbourn, Nikolaos Efstathiou
BACKGROUND: Brain injury can occur after cardiac arrest due to the effects of ischaemia and reperfusion. In serious cases this can lead to permanent disability. This risk must be considered when making decisions about terminating resuscitation. There are very specific rules for termination of resuscitation in the prehospital setting however a similar rule for resuscitation in hospital does not exist. The aim of this review was to explore the effects of duration of cardiopulmonary resuscitation on neurological outcome in survivors of both in-hospital and out-of-hospital cardiac arrest achieving return of spontaneous circulation in hospital...
September 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30201016/lightning-accidents-in-the-austrian-alps-a-10-year-retrospective-nationwide-analysis
#8
Mathias Ströhle, Bernd Wallner, Michael Lanthaler, Simon Rauch, Hermann Brugger, Peter Paal
BACKGROUND: Lightning strikes are rare but potentially lethal. The risk for suffering a lightning strike in a mountain environment is unknown. The aim of this nationwide study was to analyse all lightning accidents in the Austrian Alps from 2005 to 2015, to assess the circumstances of the accident, the injury pattern as well as the outcome. METHODS: From 2005 to 2015, data from the national Austrian Alpine Police database as well as the Clinical Information System of Innsbruck Medical University Hospital were searched for the keywords lightning injury, lightning strike, lightning as well as ICD-10 Code T75...
September 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30201007/the-satisfaction-regarding-handovers-between-ambulance-and-emergency-department-nurses-an-observational-study
#9
Gijs Thomas Hovenkamp, Tycho Joan Olgers, Remco Robert Wortel, Milou Esmée Noltes, Bert Dercksen, Jan Cornelis Ter Maaten
BACKGROUND: A thorough handover in the emergency department (ED) is of great importance for improving the quality and safety in the chain of care. The satisfaction of handover may reflect the quality of handover. Research to discover the variables influencing the satisfaction of handovers is scarce. The goal of this study was to determine the factors influencing the satisfaction regarding handovers from ambulance and ED nurses. METHODS: We performed a prospective observational study in the University Medical Center of Groningen...
September 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30201000/peripheral-measurements-of-venous-oxygen-saturation-and-lactate-as-a-less-invasive-alternative-for-hemodynamic-monitoring
#10
Raphaelle Avigael Chemtob, Hasse Møller-Sørensen
BACKGROUND: Peripheral measurement of venous oxygen saturation and lactate is a less invasive alternative to monitor tissue oxygenation as compared to measurements from a central venous catheter. However, there is a lack of evidence to support the use of peripheral measurements. In this study, we investigated the agreement between central and peripheral venous oxygen saturation and lactate. METHODS: We conducted a prospective observational study including 115 patients who underwent elective cardiac surgery between April and May 2015 at Rigshospitalet, Copenhagen, Denmark...
September 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30189887/assessment-of-laypersons-paediatric-basic-life-support-and-foreign-body-airway-obstruction-management-skills-a-validity-study
#11
Asbjørn Hasselager, Doris Østergaard, Tim Kristensen, Claus Sønderskov, Cathrine Bohnstedt, Torsten L B Lauritsen, Lars Konge, Martin G Tolsgaard
BACKGROUND: Standardised courses for laypeople in Paediatric Basic Life Support (PBLS) and Foreign Body Airway Obstruction Management (FBAOM) teach essential skills for the initiation of resuscitation by bystanders. Performance assessments are necessary to ensure that skills are acquired. We aimed to examine the validity of developed performance assessments and to determine credible pass/fail standards. METHODS: Validity evidence was gathered in a standardised simulated setting by testing participants with three different levels of PBLS/FBAOM experience: untrained laypersons, trained laypersons, and lifeguards...
September 6, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30185223/linking-the-severity-of-illness-and-the-weekend-effect-a-cohort-study-examining-emergency-department-visits
#12
Iben Duvald, Anders Moellekaer, Mathias A Boysen, Betina Vest-Hansen
BACKGROUND: Despite extensive research on the "weekend effect" i.e., the increased mortality associated with hospital admission during weekend, knowledge about disease severity in previous studies is limited. The aim of this study is to examine patient characteristics, including disease severity, 30-day mortality, and length of stay (LOS), according to time of admission to an emergency department. METHODS: Our study encompassed all patients admitted to a Danish emergency department in 2014-2015...
September 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30185205/prehospital-infection-control-and-prevention-in-denmark-a-cross-sectional-study-on-guideline-adherence-and-microbial-contamination-of-surfaces
#13
Heidi Storm Vikke, Matthias Giebner, Hans Jørn Kolmos
BACKGROUND: Prehospital acute care and treatment have become more complex, and while invasive procedures are standard procedures, focus on infection control and prevention is scarce. We aimed to evaluate guideline adherence, microbial contamination, and associated risk factors. METHODS: In a nationwide cross-sectional study, we evaluated guideline adherence to thorough cleaning (TC) once a day, and moderate cleaning (MC) in-between patient courses. Microbial contamination on hand-touch sites (HTS) and provider-related sites (PRS) was assessed by total aerobic colony forming units (CFU) and presence of selected pathogens, using swab and agar imprints...
September 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30165909/mechanical-versus-manual-chest-compressions-in-the-treatment-of-in-hospital-cardiac-arrest-patients-in-a-non-shockable-rhythm-a-randomised-controlled-feasibility-trial-compress-rct
#14
Keith Couper, Tom Quinn, Ranjit Lall, Anne Devrell, Barry Orriss, Kate Seers, Joyce Yeung, Gavin D Perkins
BACKGROUND: Mechanical chest compression devices consistently deliver high-quality chest compressions. Small very low-quality studies suggest mechanical devices may be effective as an alternative to manual chest compressions in the treatment of adult in-hospital cardiac arrest patients. The aim of this feasibility trial is to assess the feasibility of conducting an effectiveness trial in this patient population. METHODS: COMPRESS-RCT is a multi-centre parallel group feasibility randomised controlled trial, designed to assess the feasibility of undertaking an effectiveness to compare the effect of mechanical chest compressions with manual chest compressions on 30-day survival following in-hospital cardiac arrest...
August 30, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30153859/use-of-the-prognostic-biomarker-supar-in-the-emergency-department-improves-risk-stratification-but-has-no-effect-on-mortality-a-cluster-randomized-clinical-trial-triage-iii
#15
Martin Schultz, Line Jee Hartmann Rasmussen, Malene H Andersen, Jakob S Stefansson, Alexander C Falkentoft, Morten Alstrup, Andreas Sandø, Sarah L K Holle, Jeppe Meyer, Peter B S Törnkvist, Thomas Høi-Hansen, Erik Kjøller, Birgitte Nybo Jensen, Morten Lind, Lisbet Ravn, Thomas Kallemose, Theis Lange, Lars Køber, Lars Simon Rasmussen, Jesper Eugen-Olsen, Kasper Karmark Iversen
BACKGROUND: Risk stratification of patients in the emergency department can be strengthened using prognostic biomarkers, but the impact on patient prognosis is unknown. The aim of the TRIAGE III trial was to investigate whether the introduction of the prognostic and nonspecific biomarker: soluble urokinase plasminogen activator receptor (suPAR) for risk stratification in the emergency department reduces mortality in acutely admitted patients. METHODS: The TRIAGE III trial was a cluster-randomized interventional trial conducted at emergency departments in the Capitol Region of Denmark...
August 28, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30134933/prehospital-treatment-of-patients-with-acute-intracranial-pathology-adherence-to-guidelines-and-blood-pressure-recommendations-by-the-danish-air-ambulance
#16
Joachim Juelsgaard, Leif Rognås, Lars Knudsen, Troels Martin Hansen, Mads Rasmussen
BACKGROUND: Hypoxia and hypotension may be associated with secondary brain injury and negative outcomes in patients with traumatic and non-traumatic intracranial pathology. Guidelines exist only for the prehospital management of patients with severe traumatic brain injury (TBI). In patients with non-traumatic intracranial pathology, TBI guideline recommendations may be applied to assess whether hypoxia and hypotension should be avoided during prehospital treatment. The main study objective was to assess the extent to which Danish Helicopter Emergency Medical Service (HEMS) critical care teams adhere to the prehospital TBI guideline recommendations for the management of patients with a clinical diagnosis of non-traumatic intracranial pathology or isolated TBI...
August 22, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30119640/the-long-term-outcomes-and-health-related-quality-of-life-of-patients-following-blunt-thoracic-injury-a-narrative-literature-review
#17
REVIEW
Edward Baker, Andreas Xyrichis, Christine Norton, Philip Hopkins, Geraldine Lee
BACKGROUND: Major Trauma remains a leading cause of mortality and morbidity worldwide. Blunt Thoracic Injury (BTI) accounts for > 15% of United Kingdom (UK) trauma admissions and is consistently associated with respiratory related complications that include pneumonia and respiratory failure. Despite this, it is unclear in current clinical practice how BTI impacts on the recovering trauma patients after discharge from hospital. This study aimed to investigate the state of knowledge on the impact of BTI on the long-term outcomes and health-related quality of life (HRQoL)...
August 17, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30111347/ehac-medical-working-group-best-practice-advice-on-the-role-of-air-rescue-and-pre-hospital-critical-care-at-major-incidents
#18
Julian Thompson, Marius Rehn, Stephen J M Sollid
BACKGROUND: Helicopter EMS (HEMS) teams may perform a variety of clinical, managerial and transport functions during major incident management. Despite national and international variations in HEMS systems, the rapid delivery of HEMS personnel with advanced skills in major incident management and clinical scene leadership has been crucial to the delivery of an effective medical response at previous incidents. This document outlines the Best Practice Advice of the European HEMS and Air Ambulance Committee (EHAC) Medical Working Group on how HEMS and Pre Hospital Critical Care teams may maximise the positive impact of their resources in the event of Major Incidents...
August 15, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30111342/how-do-external-factors-contribute-to-the-hypocoagulative-state-in-trauma-induced-coagulopathy-in-vitro-analysis-of-the-lethal-triad-in-trauma
#19
Michael Caspers, Nadine Schäfer, Matthias Fröhlich, Ursula Bauerfeind, Bertil Bouillon, Manuel Mutschler, Marc Maegele
BACKGROUND: External factors following trauma and iatrogenic intervention influence blood coagulation and particularly clot formation. In particular, three external factors (in detail dilution via uncritical volume replacement, acidosis and hypothermia), in combination, referred to as the "lethal triad", substantially aggravate the hypocoagulative state after trauma. Contribution of these external factors to the resulting hypocoagulative state in trauma and especially their influence on primary haemostasis has still not been investigated systematically...
August 15, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30107855/undertriage-of-major-trauma-patients-at-a-university-hospital-a-retrospective-cohort-study
#20
Terje Nordgarden, Peter Odland, Anne Berit Guttormsen, Kristina Stølen Ugelvik
BACKGROUND: Studies show increased mortality among severely injured patients not met by trauma team. Proper triage is important to ensure that all severely injured patients receive vital trauma care. In 2017 a new national trauma plan was implemented in Norway, which recommended the use of a modified version of "Guidelines for Field Triage of Injured Patients" to identify severely injured patients. METHODS: A retrospective study of 30,444 patients admitted to Haukeland University Hospital in 2013, with ICD-10 injury codes upon discharge...
August 14, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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