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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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https://www.readbyqxmd.com/read/30413213/the-accuracy-of-medical-dispatch-a-systematic-review
#1
REVIEW
K Bohm, L Kurland
BACKGROUND: It is a challenge to dispatch Emergency medical Services (EMS) appropriately with limited resources and maintaining patient safety; this requires accurate dispatching systems. The objective of the current systematic review was to examine the evidence, according to GRADE, for medical dispatching systems to accurately dispatch EMS according to level of acuity and in recognition of specific conditions. A systematic search was performed trough PubMed, Web of Science, Embase (free text in all fields), Centre for Reviews and Dissemination (CRD), and Cochrane Central Register of Controlled Trials up to 16th of May, 2017...
November 9, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30413210/a-prediction-model-for-good-neurological-outcome-in-successfully-resuscitated-out-of-hospital-cardiac-arrest-patients
#2
Ward Eertmans, Thao Mai Phuong Tran, Cornelia Genbrugge, Laurens Peene, Dieter Mesotten, Jo Dens, Frank Jans, Cathy De Deyne
BACKGROUND: In the initial hours after out-of-hospital cardiac arrest (OHCA), it remains difficult to estimate whether the degree of post-ischemic brain damage will be compatible with long-term good neurological outcome. We aimed to construct prognostic models able to predict good neurological outcome of OHCA patients within 48 h after CCU admission using variables that are bedside available. METHODS: Based on prospectively gathered data, a retrospective data analysis was performed on 107 successfully resuscitated OHCA patients with a presumed cardiac cause of arrest...
November 9, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30400803/treat-me-nice-a-cross-sectional-study-examining-support-during-the-first-year-in-the-emergency-medical-services
#3
Anna Hörberg, Susanne Kalén, Maria Jirwe, Max Scheja, Veronica Lindström
BACKGROUND: Working in the emergency medical service (EMS) can be extremely varying and sometimes physically and psychologically demanding. Being new in this context can be a great challenge. This study aim to describe what ambulance nurses consider to be important support during the first year in the EMS. METHODS: Three hundred and eighty-nine eligible participants that had graduated from the prehospital emergency care program were identified via university registrations office in Sweden...
November 6, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30373652/a-retrospective-comparison-between-non-conveyed-and-conveyed-patients-in-ambulance-care
#4
Lilian C M Vloet, Arjan de Kreek, Emmelieke M C van der Linden, Jori J A van Spijk, Vince A H Theunissen, Maud van Wanrooij, Pierre M van Grunsven, Remco H A Ebben
BACKGROUND: Not all patients where an ambulance is dispatched are conveyed to an emergency department. Although non-conveyance is a substantial part of ambulance care, there is limited insight in the non-conveyance patient population. Therefore, the study aim was to compare demographics, initial on-scene reasons for care, and vital signs between conveyed and non-conveyed patients attended by an ambulance. METHODS: A retrospective study of ambulance runs from 2 EMS regions in the Netherlands in 2016 was performed...
October 29, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30373641/best-practice-guidelines-for-blunt-cerebrovascular-injury-bcvi
#5
REVIEW
Tor Brommeland, Eirik Helseth, Mads Aarhus, Kent Gøran Moen, Stig Dyrskog, Bo Bergholt, Zandra Olivecrona, Elisabeth Jeppesen
Blunt cerebrovascular injury (BCVI) is a non-penetrating injury to the carotid and/or vertebral artery that may cause stroke in trauma patients. Historically BCVI has been considered rare but more recent publications indicate an overall incidence of 1-2% in the in-hospital trauma population and as high as 9% in patients with severe head injury. The indications for screening, treatment and follow-up of these patients have been controversial for years with few clear recommendations. In an attempt to provide a clinically oriented guideline for the handling of BCVI patients a working committee was created...
October 29, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30342543/airway-management-in-pre-hospital-critical-care-a-review-of-the-evidence-for-a-top-five-research-priority
#6
REVIEW
K Crewdson, M Rehn, D Lockey
The conduct and benefit of pre-hospital advanced airway management and pre-hospital emergency anaesthesia have been widely debated for many years. In 2011, prehospital advanced airway management was identified as a 'top five' in physician-provided pre-hospital critical care. This article summarises the evidence for and against this intervention since 2011 and attempts to address some of the more controversial areas of this topic.
October 20, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30340516/structured-analysis-evaluation-and-report-of-the-emergency-response-to-a-terrorist-attack-in-wuerzburg-germany-using-a-new-template-of-standardised-quality-indicators
#7
T Wurmb, N Schorscher, P Justice, S Dietz, R Schua, T Jarausch, U Kinstle, J Greiner, G Möldner, J Müller, M Kraus, S Simon, U Wagenhäuser, J Hemm, N Roewer, M Helm
BACKGROUND: Until now there has been a reported lack of systematic reports and scientific evaluations of rescue missions during terror attacks. This however is urgently required in order to improve the performance of emergency medical services and to be able to compare different missions with each other. Aim of the presented work was to report the systematic evaluation and the lessons learned from the response to a terror attack that happened in Wuerzburg, Germany in 2016. METHODS: A team of 14 experts developed a template of quality indicators and operational characteristics, which allow for the description, assessment and comparison of civil emergency rescue missions during mass killing incidents...
October 19, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30340502/initial-assessment-level-of-care-and-outcome-among-children-who-were-seen-by-emergency-medical-services-a-prospective-observational-study
#8
Carl Magnusson, Johan Herlitz, Thomas Karlsson, Christer Axelsson
BACKGROUND: The assessment of children in the Emergency Medical Service (EMS) is infrequent representing 5.4% of the patients in an urban area in the western part of Sweden. In Sweden, patients are assessed on scene by an EMS nurse whom independently decides on interventions and level of care. To aid the EMS nurse in the assessment a triage instrument, Rapid Emergency Triage and Treatment System-paediatrics (RETTS-p) developed for Emergency Department (ED) purpose has been in use the last 5 years...
October 19, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30309373/the-effect-of-bystander-cardiopulmonary-resuscitation-on-the-survival-of-out-of-hospital-cardiac-arrests-a-systematic-review-and-meta-analysis
#9
REVIEW
Jianting Song, Wenxiu Guo, Xiaoguang Lu, Xin Kang, Yi Song, Dianbo Gong
BACKGROUND: For many years, bystander cardiopulmonary resuscitation (BCPR) has been considered as a favorable factor to improve survival of out-of-hospital cardiac arrests (OHCAs). To examine the effect of BCPR on the survival of OHCAs and whether BCPR might also improve survival when the initial rhythm of OHCAs is limited, we performed a meta-analysis on published observational studies. METHODS: We did a systematic review to identify all studies published up to March, 2018, in any language, that reported the relation between BCPR and the survival of OHCAs...
October 11, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30261906/cardiac-arrest-teams-perspectives-on-communication-and-ethical-conflicts-related-to-awareness-during-cpr-a-focus-group-study-protocol
#10
Rune Sarauw Lundsgaard, Kristine Sarauw Lundsgaard
BACKGROUND: Awareness during Cardio Pulmonary Resuscitation (CPR) also called CPR induced consciousness (CPRIC) is a rare, but increasingly reported condition with significant clinical implications. Health professionals lack guidelines about patients with CPRIC, and to this date, no studies have addressed the complexity of communication and ethical aspects when continuing CPR while the patient is conscious. METHODS: We aim to explore Cardiac arrest team members perspectives regarding communication and ethical conflicts related to awareness during CPR...
September 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30253795/a-novel-method-of-non-clinical-dispatch-is-associated-with-a-higher-rate-of-critical-helicopter-emergency-medical-service-intervention
#11
Scott Munro, Mark Joy, Richard de Coverly, Mark Salmon, Julia Williams, Richard M Lyon
BACKGROUND: Helicopter Emergency Medical Services (HEMS) are a scarce resource that can provide advanced emergency medical care to unwell or injured patients. Accurate tasking of HEMS is required to incidents where advanced pre-hospital clinical care is needed. We sought to evaluate any association between non-clinically trained dispatchers, following a bespoke algorithm, compared with HEMS paramedic dispatchers with respect to incidents requiring a critical HEMS intervention. METHODS: Retrospective analysis of prospectively collected data from two 12-month periods was performed (Period one: 1st April 2014 - 1st April 2015; Period two: 1st April 2016 - 1st April 2017)...
September 25, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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