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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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https://read.qxmd.com/read/31068199/live-video-footage-from-scene-to-aid-helicopter-emergency-medical-service-dispatch-a-feasibility-study
#1
E Ter Avest, E Lambert, R de Coverly, H Tucker, J Griggs, M H Wilson, A Ghorbangholi, J Williams, R M Lyon
BACKGROUND: Obtaining accurate information from a 112 caller is key to correct tasking of Helicopter Emergency Medical Services (HEMS). Being able to view the incident scene via video from a mobile phone may assist HEMS dispatch by providing more accurate information such as mechanism of injury and/or injuries sustained. The objective of this study is to describe the acceptability and feasibility of using live video footage from the mobile phone of a 112 caller as an HEMS dispatch aid...
May 8, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/31068188/diagnostic-error-increases-mortality-and-length-of-hospital-stay-in-patients-presenting-through-the-emergency-room
#2
Wolf E Hautz, Juliane E Kämmer, Stefanie C Hautz, Thomas C Sauter, Laura Zwaan, Aristomenis K Exadaktylos, Tanja Birrenbach, Volker Maier, Martin Müller, Stefan K Schauber
BACKGROUND: Diagnostic errors occur frequently, especially in the emergency room. Estimates about the consequences of diagnostic error vary widely and little is known about the factors predicting error. Our objectives thus was to determine the rate of discrepancy between diagnoses at hospital admission and discharge in patients presenting through the emergency room, the discrepancies' consequences, and factors predicting them. METHODS: Prospective observational clinical study combined with a survey in a University-affiliated tertiary care hospital...
May 8, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/31046804/socioeconomic-disparities-in-prehospital-stroke-care
#3
Amanda Niklasson, Johan Herlitz, Katarina Jood
BACKGROUND AND PURPOSE: Recent studies have revealed socioeconomic disparities in stroke outcomes. Here, we investigated whether prehospital stroke care differs with respect to socioeconomic status (SES). METHODS: Consecutive stroke and TIA patients (n = 3006) admitted to stroke units at Sahlgrenska University Hospital, Gothenburg, Sweden, from 1 November 2014 to 31 July 2016, were included. Data on prehospital care were obtained from a local stroke register...
May 2, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/31039813/prognostic-accuracy-of-the-serum-lactate-level-the-sofa-score-and-the-qsofa-score-for-mortality-among-adults-with-sepsis
#4
Zhiqiang Liu, Zibo Meng, Yongfeng Li, Jingyuan Zhao, Shihong Wu, Shanmiao Gou, Heshui Wu
BACKGROUND: Sepsis is a common critical condition caused by the body's overwhelming response to certain infective agents. Many biomarkers, including the serum lactate level, have been used for sepsis diagnosis and guiding treatment. Recently, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) recommended the Sequential Organ Failure Assessment (SOFA) and the quick SOFA (qSOFA) rather than lactate for screening sepsis and assess prognosis. Here, we aim to explore and compare the prognostic accuracy of the lactate level, the SOFA score and the qSOFA score for mortality in septic patients using the public Medical Information Mart for Intensive Care III database (MIMIC III)...
April 30, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/31039800/a-prospective-stepped-wedge-cohort-evaluation-of-the-new-national-trauma-team-activation-criteria-in-sweden-the-traumalert-study
#5
Fredrik Linder, Lina Holmberg, Martin Bjorck, Claes Juhlin, Knut Thorbjornsen, Jan Wisinger, Per Polleryd, Hampus Eklof, Kevin Mani
BACKGROUND: Trauma triage based on prehospital information facilitates correct allocation of in-hospital resources. The Swedish national two-tier trauma team activation (TTA) criteria were revised in 2016. The current study aimed to evaluate the safety and efficacy of the new criteria. METHODS: Five centres covering trauma care for 1.2 million inhabitants registered all trauma patients prospectively in the Swedish trauma registry (SweTrau) prior to and after stepwise introduction of new TTA criteria within the cohort (a prospective stepped-wedge cohort study design; period August 2016-November 2017)...
April 30, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/31018857/the-heaven-criteria-predict-laryngoscopic-view-and-intubation-success-for-both-direct-and-video-laryngoscopy-a-cohort-analysis
#6
Fauzia Nausheen, Nichole P Niknafs, Derek J MacLean, David J Olvera, Allen C Wolfe, Troy W Pennington, Daniel P Davis
BACKGROUND: Existing difficult airway prediction tools are not practical for emergency intubation and do not incorporate physiological data. The HEAVEN criteria (Hypoxaemia, Extremes of size, Anatomic challenges, Vomit/blood/fluid, Exsanguination, Neck mobility) may be more relevant for emergency rapid sequence intubation (RSI). METHODS: A retrospective analysis included air medical RSI patients. A checklist was used to assess HEAVEN criteria prior to RSI, and Cormack-Lehane (CL) laryngoscopic view was recorded for the first intubation attempt...
April 24, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/31014373/application-of-prothrombin-complex-concentrate-for-reversal-of-direct-oral-anticoagulants-in-clinical-practice-indications-patient-characteristics-and-clinical-outcomes-compared-to-reversal-of-vitamin-k-antagonists
#7
Martin Müller, Jonathan Eastline, Michael Nagler, Aristomenis K Exadaktylos, Thomas C Sauter
BACKGROUND: Prothrombin complex concentrate (PCC) is widely used to reverse the action of direct oral anticoagulants (DOACs) in accordance with current guidelines and because of a lack of specific reversal agents. Indications, clinical characteristics and patient outcomes of patients might differ in comparison to reversal of vitamin K antagonists where reversal with PCC is well established. METHODS: Our cohort study explores patient characteristics, indications and clinical outcomes for reversal of all DOAC patients receiving PCC at our university emergency department from 01...
April 23, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/31014372/a-paediatric-case-of-severe-tracheobronchial-injury-successfully-treated-surgically-after-early-ct-diagnosis-and-ecmo-safely-performed-in-the-hybrid-emergency-room
#8
Daiki Wada, Koichi Hayakawa, Shuhei Maruyama, Fukuki Saito, Hiroyuki Kaneda, Yasushi Nakamori, Yasuyuki Kuwagata
BACKGROUND: In paediatric trauma patients, tracheobronchial injury can be a rare, life-threatening trauma. In 2011, we instituted a new trauma workflow concept called the hybrid emergency room (Hybrid ER) that combines a sliding CT scanning system with interventional radiology features to permit CT examination and emergency therapeutic intervention without moving the patient. Extracorporeal membrane oxygenation (ECMO) can lead to cannula-related complications. However, procedures supported by moveable C-arm fluoroscopy and ultrasonography equipment can be performed soon after early CT examination...
April 23, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30995939/injury-registration-for-primary-prevention-in-a-provincial-russian-region-setting-up-a-new-trauma-registry
#9
Tatiana N Unguryanu, Andrej M Grjibovski, Tordis A Trovik, Børge Ytterstad, Alexander V Kudryavtsev
BACKGROUND: The Shenkursk Injury Registry (SHIR) was established in the Shenkursk District, Northwestern Russia in 2015 for the purposes of primary prevention. The SHIR covers all injuries (ICD-10 diagnoses from S00 to T78) for which medical aid is given at the Shenkursk central district hospital and includes data about injury circumstances. We used the SHIR data to assess the quality of the SHIR as an evidence basis and for the local preventive applications. METHODS: Completeness, representativeness, and reliability of the SHIR data were assessed using a sample of 1696 injuries which have occurred in July 2015-June 2016...
April 17, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30992042/repeated-ambulance-use-is-associated-with-chronic-diseases-a-population-based-historic-cohort-study-of-patients-symptoms-and-diagnoses
#10
Morten Breinholt Søvsø, Torben Anders Kløjgaard, Poul Anders Hansen, Erika Frischknecht Christensen
BACKGROUND: There is a growing demand for emergency medical services (EMS) and patients are repeatedly transported by ambulance services. For many patients, especially those with chronic disease, there may be better ways of delivering care. We examined the symptom at time of emergency call and the hospital diagnosis for those ambulance users who repeatedly received an ambulance. METHODS: Population-based historic cohort study of patients receiving an ambulance after an emergency call between 2011 and 2014: one-time users (i...
April 16, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30992028/chest-wall-thickness-and-depth-to-vital-structures-in-paediatric-patients-implications-for-prehospital-needle-decompression-of-tension-pneumothorax
#11
Tom Terboven, Georg Leonhard, Lucas Wessel, Tim Viergutz, Marcus Rudolph, Michael Schöler, Meike Weis, Holger Haubenreisser
BACKGROUND: Recommendations regarding decompression of tension pneumothorax in small children are scarce and mainly transferred from the adult literature without existing evidence for the paediatric population. This CT-based study evaluates chest wall thickness, width of the intercostal space (ICS) and risk of injury to vital structures by needle decompression in children. METHODS: Chest wall thickness, width of the intercostal space and depth to vital structures were measured and evaluated at 2nd ICS midclavicular (MCL) line and 4th ICS anterior axillary line (AAL) on both sides of the thorax using computed tomography (CT) in 139 children in three different age groups (0, 5, 10 years)...
April 16, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30975182/key-performance-indicators-for-pre-hospital-emergency-anaesthesia-a-suggested-approach-for-implementation
#12
James Raitt, James Hudgell, Henry Knott, Syed Masud
BACKGROUND: Pre-hospital Emergency Anaesthesia (PHEA) is regarded as one of the highest risk interventions that pre-hospital providers perform. AAGBI guidance from 2017 suggests the use of Key Performance Indicators (KPIs) to audit PHEA quality. The aim of this study was to develop KPIs for use in our service and evaluate their impact. METHODS: Using the AAGBI 2017 document as a guide we developed a list of ten auditable domains. Data for each case was extracted from the Electronic Patient Record (EPR) and a score assigned to each of the domains; one if the domain is achieved and zero if the domain is not achieved or if data is missing, giving a total score out of ten...
April 11, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30975178/availability-of-supar-in-emergency-departments-may-improve-risk-stratification-a-secondary-analysis-of-the-triage-iii-trial
#13
Martin Schultz, Line J H Rasmussen, Thomas Kallemose, Erik Kjøller, Morten N Lind, Lisbet Ravn, Theis Lange, Lars Køber, Lars S Rasmussen, Jesper Eugen-Olsen, Kasper Iversen
INTRODUCTION: Soluble urokinase plasminogen activator receptor (suPAR) is a prognostic and nonspecific biomarker associated with short-term mortality in emergency department (ED) patients. Therefore, the blood level of suPAR might be usable for identification of patients at high- and low risk, shortly after arrival at the ED. Here, we investigate the value of adding suPAR to triage and how this may impact on risk stratification regarding mortality. METHODS: The analyses were performed on the TRIAGE III cohort...
April 11, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30975160/impact-of-caller-s-degree-of-worry-on-triage-response-in-out-of-hours-telephone-consultations-a-randomized-controlled-trial
#14
Hejdi Gamst-Jensen, Erika Frishknecht Christensen, Freddy Lippert, Fredrik Folke, Ingrid Egerod, Mikkel Brabrand, Janne Schurmann Tolstrup, Lau Caspar Thygesen, Linda Huibers
BACKGROUND: Telephone triage entails assessment of urgency and direction of flow in out-of-hours (OOH) services, while visual cues are inherently lacking. Triage tools are recommended but current tools fail to provide systematic assessment of the caller's perspective. Research demonstrated that callers can scale their degree-of-worry (DOW) in a telephone contact with OOH services, but its impact on triage response is undetermined. The aim of this study was to investigate the association between call-handlers' awareness of the caller's DOW and the telephone triage response...
April 11, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30971299/could-we-employ-the-queueing-theory-to-improve-efficiency-during-future-mass-causality-incidents
#15
Chih-Chuan Lin, Chin-Chieh Wu, Chi-Dan Chen, Kuan-Fu Chen
BACKGROUND: Preparation for a disaster or accident-related mass casualty events is often based on experience. The objective measures or tools for evaluating decision-making and effectiveness during such events are underdeveloped. Queueing theory has been suggested to evaluate the effectiveness of mass causality incidents (MCI) plans. OBJECTIVE: Using different types of real MCI, we aimed to determine if a queueing network model could be used as a tool to assist in preparing plans to address mass causality incidents...
April 11, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30961651/drone-delivery-of-an-automated-external-defibrillator-a-mixed-method-simulation-study-of-bystander-experience
#16
J Sanfridsson, J Sparrevik, J Hollenberg, P Nordberg, T Djärv, M Ringh, L Svensson, S Forsberg, A Nord, M Andersson-Hagiwara, A Claesson
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) affects some 275,000 individuals in Europe each year. Time from collapse to defibrillation is essential for survival. As emergency medical services (EMS) response times in Sweden have increased, novel methods are needed to facilitate early treatment. Unmanned aerial vehicles (i.e. drones) have potential to deliver automated external defibrillators (AED). The aim of this simulation study was to explore bystanders' experience of a simulated OHCA-situation where a drone delivers an AED and how the situation is affected by having one or two bystanders onsite...
April 8, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30961648/the-effects-of-prehospital-system-delays-on-the-treatment-efficacy-of-stemi-patients
#17
Magdalena Żurowska-Wolak, Patryk Piekos, Jacek Jąkała, Marcin Mikos
BACKGROUND: Cardiovascular disease accounts for nearly half of all deaths in Poland. The aim of this study was to assess both the duration and the delays of prehospital treatment in ST-segment elevation myocardial infarction (STEMI) patients and how it impacts left ventricle ejection fraction (LVEF) measured at the time of discharge and the frequency of in-hospital patient mortality. METHODS: This study retrospectively analyzed medical records from January 2011 to December 2015 (excluding the year 2013) of 573 patients who were transported to a hospital with a diagnosis of STEMI...
April 8, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30953564/the-danish-helicopter-emergency-medical-service-database-high-quality-data-with-great-potential
#18
Karen Alstrup, Jens Aage Kølsen Petersen, Charlotte Barfod, Lars Knudsen, Leif Rognås, Thea Palsgaard Møller
BACKGROUND: The Danish Helicopter Emergency Medical Service (HEMS) is part of the Danish pre-hospital response offering advanced patient care on scene and during rapid transport to definitive care. Monitoring HEMS performance and the quality of critical care has high national as well as international priority underlining the need for research in this field. The data quality of the Danish HEMS database is unknown. Furthermore, a set of quality indicators (QI) developed by an international collaboration group (EQUIPE) potentially for use in physician-staffed EMS, has recently been presented...
April 5, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30953532/comment-on-unplanned-out-of-hospital-birth-and-risk-factors-of-adverse-perinatal-outcome-findings-from-a-prospective-cohort
#19
LETTER
Razieh Bidhendi Yarandi, Mohammad Hossein Panahi
The aim of this Letter to the Editor was to report some methodological shortcomings in a recently published Article. We proved that the obtained results are subjected to the sparse data bias and presented some remedial tools such as penalization approaches. In addition, model fitting and performance aroused some controversies. In conclusion, the results of this study should be interpreted with caution and further reanalysis is necessary.
April 5, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30940205/diagnostic-accuracy-of-physician-staffed-emergency-medical-teams-a-retrospective-observational-cohort-study-of-prehospital-versus-hospital-diagnosis-in-a-10-year-interval
#20
Jens-Christian Schewe, Jochen Kappler, Katharina Dovermann, Ingo Graeff, Stefan Felix Ehrentraut, Ulrich Heister, Andreas Hoeft, Stefan Ulrich Weber, Stefan Muenster
BACKGROUND: In Germany, emergency medical teams are staffed with physicians but evidence regarding their prehospital diagnostic accuracy remains poor. OBJECTIVE: To evaluate the out-of-hospital diagnostic accuracy of physician-staffed emergency medical teams (PEMTs). METHODS: A retrospective observational cohort study involving the Emergency Medical Service Bonn, Germany, from January to December 2004 and 2014 respectively. A total of 8346 patients underwent medical treatment by PEMTs, of which 1960 adult patients (inclusion criteria: ≥18 years of age, hospital diagnosis available) were included for further analysis...
April 2, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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