Articles

Patient and rescuer safety: recommendations for dispatch and prioritization of rescue resources based on a retrospective study of Norwegian avalanche incidents 1996–2017

Avalanche emergency response should address current accident scenarios to optimize survival chances of victims and to keep rescuers safe. The purpose of this article is to present a basis for evaluation and ne...

Authors: Albert Lunde and Christen Tellefsen

Hospital level variations in the trends and outcomes of the nonoperative management of splenic injuries – a nationwide cohort study

The long-term treatment trends of splenic injuries can provide guidance when treating trauma patients. The nonoperative management (NOM) of splenic injuries was introduced in early 1989. After decades of devel...

Authors: Chien-An Liao, Yu-Tung Wu, Chien-Hung Liao, Shang-Yu Wang, Chih-Yuan Fu, Chi-Hsun Hsieh, Shao-Wei Chen, Ching-Chang Chen, An-Hsun Chou and Chi-Tung Cheng

Pre-hospital management of acute stroke patients eligible for thrombolysis – an evaluation of ambulance on-scene time

Stroke is a leading cause of death and disability with effective treatment, including thrombolysis or thrombectomy, being time-critical for favourable outcomes. While door-to-needle time in hospital has been o...

Authors: Nicolas Drenck, Søren Viereck, Josefine Stokholm Bækgaard, Karl Bang Christensen, Freddy Lippert and Fredrik Folke

Actual clinical leadership: a shadowing study of charge nurses and doctors on-call in the emergency department

The provision of safe, high quality healthcare in the Emergency Department (ED) requires frontline healthcare personnel with sufficient competence in clinical leadership. However, healthcare education curricul...

Authors: Sissel Eikeland Husebø and Øystein Evjen Olsen

Training and assessment of non-technical skills in Norwegian helicopter emergency services: a cross-sectional and longitudinal study

Deficient non-technical skills (NTS) among providers of critical care in helicopter emergency medical services (HEMS) is a threat to patient and operational safety. Skills can be improved through simulation-ba...

Authors: Kristen Rasmussen, Henrik Langdalen, Stephen J. M. Sollid, Eirik Bjorheim Abrahamsen, Leif Inge K. Sørskår, Gunnar Tschudi Bondevik and Håkon B. Abrahamsen

The final assessment and its association with field assessment in patients who were transported by the emergency medical service

In patients who call for the emergency medical service (EMS), there is a knowledge gap with regard to the final assessment after arriving at hospital and its association with field assessment.

Authors: Carl Magnusson, Christer Axelsson, Lena Nilsson, Anneli Strömsöe, Monica Munters, Johan Herlitz and Magnus Andersson Hagiwara

Comparison of a novel, endoscopic chest tube insertion technique versus the standard, open technique performed by novice users in a human cadaver model: a randomized, crossover, assessor-blinded study

The technique of tube thoracostomy has been standardized for years without significant updates. Alternative procedural methods may be beneficial in certain prehospital and inpatient environments with limited r...

Authors: Byron C. Drumheller, Anthony Basel, Sakib Adnan, Joseph Rabin, Jason D. Pasley, Jason Brocker and Samuel M. Galvagno Jr

Effects of NaHS and hydroxylamine on the expressions of brain-derived neurotrophic factor and its receptors in rats after cardiac arrest and cardiopulmonary resuscitation

H₂S can also protect nerve cells. The objective of the study is to investigate the effects of hydrogen sulfide (H₂S) on the expressions of brain-derived neurotrophic factor (BDNF) and its receptors, tyrosine prot...

Authors: Jiyan Lin, Weicheng Wu, Zhihong Xu, Siyao Liu, Wang Lu and Mandong Pan

Survival of in-hospital cardiac arrest in men and women in a large Swedish cohort

Cardiac arrest is more common in men than women and a few studies have shown inferior 30-day survival for men than for women. The difference might relate to patient characteristics, intra arrest factors or pos...

Authors: Angelika Qvick, Manar Radif, Caroline Brever, Jenny Olsson Myrvik, Karin Schenk Gustafsson and Therese Djärv

Risks and benefits of hypotensive resuscitation in patients with traumatic hemorrhagic shock: a meta-analysis

Damage control strategies play an important role in trauma patient management. One such strategy, hypotensive resuscitation, is being increasingly employed. Although several randomized controlled trials have r...

Authors: Natthida Owattanapanich, Kaweesak Chittawatanarat, Thoetphum Benyakorn and Jatuporn Sirikun

Prognostic value of gasping for short and long outcomes during out-of-hospital cardiac arrest: an updated systematic review and meta-analysis

We systematically reviewed the literature to investigate whether gasping could predict short and long outcomes in patients with out of hospital cardiac arrest (OHCA).

Authors: Qiang Zhang, Bo Liu, Zhijiang Qi and Chunsheng Li

Factors associated with acute kidney injury in the Helsinki Burn Centre in 2006–2015

Acute kidney injury (AKI) is a common complication in severe burns and can lead to significantly poorer outcomes. Although the prognosis has improved in recent decades, the mortality of AKI remains considerabl...

Authors: I. Rakkolainen, J. V. Lindbohm and J. Vuola

Investigating the ability of non-invasive measures of cardiac output to detect a reduction in blood volume resulting from venesection in spontaneously breathing subjects

Monitoring cardiac output (CO) in shocked patients provides key etiological information and can be used to guide fluid resuscitation to improve patient outcomes. Previously this relied on invasive monitoring, ...

Authors: Benjamin Mothibe Bussmann, William Hulme, Andrew Tang and Tim Harris

ECMO improves survival following cardiogenic shock due to carbon monoxide poisoning - an experimental porcine model

Severe intoxication with carbon monoxide (CO) is extremely lethal and causes numerous deaths due to cardiac or respiratory failure. Conventional intensive treatment may not be sufficient. The aim of this study...

Authors: Carsten Simonsen, Sigridur O. Magnusdottir, Jan J. Andreasen, Marianne Cathrine Rohde and Benedict Kjærgaard

Traumatic brain injury is associated with increased syndecan-1 shedding in severely injured patients

Head injury and exsanguination are the leading causes of death in trauma patients. Hemorrhagic shock triggers systemic endothelial glycocalyx breakdown, potentially leading to traumatic endotheliopathy (EoT). ...

Authors: Erika Gonzalez Rodriguez, Jessica C. Cardenas, Charles S. Cox, Ryan S. Kitagawa, Jakob Stensballe, John B. Holcomb, Pär I. Johansson and Charles E. Wade

Mortality of civilian patients with suspected traumatic haemorrhage receiving pre-hospital transfusion of packed red blood cells compared to pre-hospital crystalloid

Major haemorrhage is a leading cause of mortality following major trauma. Increasingly, Helicopter Emergency Medical Services (HEMS) in the United Kingdom provide pre-hospital transfusion with blood products, ...

Authors: J. E. Griggs, J. Jeyanathan, M. Joy, M. Q. Russell, N. Durge, D. Bootland, S. Dunn, E. D. Sausmarez, G. Wareham, A. Weaver and R. M. Lyon

Seven years since defining the top five research priorities in physician-provided pre-hospital critical care – what did it lead to and where are we now?

Authors: Kristi G. Bache, Marius Rehn and Julian Thompson

Factors determining level of hospital care and its association with outcome after resuscitation from pre-hospital pulseless electrical activity

Patients resuscitated from out-of-hospital cardiac arrest (OHCA) with pulseless electrical activity (PEA) as initial cardiac rhythm are not always treated in intensive care units (ICUs): some are admitted to h...

Authors: Sini SAARINEN, Ari SALO, James BOYD, Päivi LAUKKANEN-NEVALA, Catharina SILFVAST, Ilkka VIRKKUNEN and Tom SILFVAST

Comment to: non-specific complaints at emergency department presentation result in unclear diagnoses and lengthened hospitalization: a prospective observational study

Authors: Roland Bingisser and Christian H Nickel

Bone marrow-derived mononuclear cell therapy can attenuate systemic inflammation in rat heatstroke

This study was performed to gain insights into novel therapeutic approaches for acute systemic inflammation in heatstroke. Bone marrow-derived mononuclear cells (BMMNCs) secrete anti-inflammatory proteins and ...

Authors: Yutaka Umemura, Hiroshi Ogura, Hiroshi Matsuura, Takeshi Ebihara, Kentaro Shimizu and Takeshi Shimazu

The role of a checklist for assessing the quality of basic life support performance: an observational cohort study

Training lay rescuers in Basic Life Support (BLS) is essential to improve bystander cardiopulmonary resuscitation (CPR) rates; in addition, simple methods are needed to provide feedback on CPR performance. Thi...

Authors: Johanna van Dawen, Lina Vogt, Hanna Schröder, Rolf Rossaint, Lina Henze, Stefan K. Beckers and Saša Sopka

Identification and internal validation of models for predicting survival and ICU admission following a traumatic injury

Measures to improve the accuracy of determining survival and intensive care unit (ICU) admission using the International Classification of Injury Severity Score (ICISS) are not often conducted on a population-...

Authors: Rebecca J. Mitchell, Hsuen P. Ting, Tim Driscoll and Jeffrey Braithwaite

The accuracy of medical dispatch - a systematic review

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 syst...

Authors: K. Bohm and L. Kurland

A prediction model for good neurological outcome in successfully resuscitated out-of-hospital cardiac arrest patients

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. ...

Authors: Ward Eertmans, Thao Mai Phuong Tran, Cornelia Genbrugge, Laurens Peene, Dieter Mesotten, Jo Dens, Frank Jans and Cathy De Deyne

Treat me nice! –a cross-sectional study examining support during the first year in the emergency medical services

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 wh...

Authors: Anna Hörberg, Susanne Kalén, Maria Jirwe, Max Scheja and Veronica Lindström

Best practice guidelines for blunt cerebrovascular injury (BCVI)

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 publi...

Authors: Tor Brommeland, Eirik Helseth, Mads Aarhus, Kent Gøran Moen, Stig Dyrskog, Bo Bergholt, Zandra Olivecrona and Elisabeth Jeppesen

A retrospective comparison between non-conveyed and conveyed patients in ambulance care

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 patien...

Authors: 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 and Remco H. A. Ebben

Airway management in pre-hospital critical care: a review of the evidence for a ‘top five’ research priority

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...

Authors: K. Crewdson, M. Rehn and D. Lockey

Initial assessment, level of care and outcome among children who were seen by emergency medical services: a prospective observational study

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...

Authors: Carl Magnusson, Johan Herlitz, Thomas Karlsson and Christer Axelsson

Structured analysis, evaluation and report of the emergency response to a terrorist attack in Wuerzburg, Germany using a new template of standardised quality indicators

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 emer...

Authors: 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 and M Helm

The effect of bystander cardiopulmonary resuscitation on the survival of out-of-hospital cardiac arrests: a systematic review and meta-analysis

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 sur...

Authors: Jianting Song, Wenxiu Guo, Xiaoguang Lu, Xin Kang, Yi Song and Dianbo Gong

Cardiac arrest teams perspectives on communication and ethical conflicts related to awareness during CPR, a focus group study protocol

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 l...

Authors: Rune Sarauw Lundsgaard and Kristine Sarauw Lundsgaard

A novel method of non-clinical dispatch is associated with a higher rate of critical Helicopter Emergency Medical Service intervention

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 advanc...

Authors: Scott Munro, Mark Joy, Richard de Coverly, Mark Salmon, Julia Williams and Richard M. Lyon

Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load

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.

Authors: Paul Swinton, Alasdair R. Corfield, Chris Moultrie, David Percival, Jeffrey Proctor, Neil Sinclair and Zane B. Perkins

A socio-economic analysis of increased staffing in the Norwegian helicopter emergency medical service

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 a...

Authors: Eirik Bjorheim Abrahamsen, Jon Tømmerås Selvik, Anders Nordgaard Dahle, Frank Asche and Håkon Bjorheim Abrahamsen

Independent determinants of prolonged emergency department length of stay in a tertiary care centre: a prospective cohort study

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 targ...

Authors: Daniël van der Veen, Claudia Remeijer, Anne J. Fogteloo, Christian Heringhaus and Bas de Groot

First establishment of a new table-rotated-type hybrid emergency room system

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)...

Authors: Hiroaki Watanabe, Yoshihide Shimojo, Eiji Hira, Shunsuke Kuramoto, Tomohiro Muronoi, Kazuyuki Oka and Akihiko Kidani

Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study

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 object...

Authors: Wim Breeman, Nathan A. Poublon, Michael H. J. Verhofstad and Esther M. M. Van Lieshout

How does the length of cardiopulmonary resuscitation affect brain damage in patients surviving cardiac arrest? A systematic review

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 ter...

Authors: Clare Welbourn and Nikolaos Efstathiou

Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015

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. Thi...

Authors: Torge Huckhagel, Jakob Nüchtern, Jan Regelsberger and Rolf Lefering

Peripheral measurements of venous oxygen saturation and lactate as a less invasive alternative for hemodynamic monitoring

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 ...

Authors: Raphaelle Avigael Chemtob and Hasse Møller-Sørensen

Lightning accidents in the Austrian alps – a 10-year retrospective nationwide analysis

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...

Authors: Mathias Ströhle, Bernd Wallner, Michael Lanthaler, Simon Rauch, Hermann Brugger and Peter Paal

The satisfaction regarding handovers between ambulance and emergency department nurses: an observational study

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...

Authors: Gijs Thomas Hovenkamp, Tycho Joan Olgers, Remco Robert Wortel, Milou Esmée Noltes, Bert Dercksen and Jan Cornelis ter Maaten

Assessment of laypersons’ paediatric basic life support and foreign body airway obstruction management skills: a validity study

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. Perfo...

Authors: Asbjørn Hasselager, Doris Østergaard, Tim Kristensen, Claus Sønderskov, Cathrine Bohnstedt, Torsten L. B. Lauritsen, Lars Konge and Martin G. Tolsgaard

Linking the severity of illness and the weekend effect: a cohort study examining emergency department visits

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 t...

Authors: Iben Duvald, Anders Moellekaer, Mathias A. Boysen and Betina Vest-Hansen

Prehospital infection control and prevention in Denmark: a cross-sectional study on guideline adherence and microbial contamination of surfaces

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 adheren...

Authors: Heidi Storm Vikke, Matthias Giebner and Hans Jørn Kolmos

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)

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 compressi...

Authors: Keith Couper, Tom Quinn, Ranjit Lall, Anne Devrell, Barry Orriss, Kate Seers, Joyce Yeung and Gavin D. Perkins

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)

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 w...

Authors: 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…

Prehospital treatment of patients with acute intracranial pathology: adherence to guidelines and blood pressure recommendations by the Danish Air Ambulance

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 manage...

Authors: Joachim Juelsgaard, Leif Rognås, Lars Knudsen, Troels Martin Hansen and Mads Rasmussen

The long-term outcomes and health-related quality of life of patients following blunt thoracic injury: a narrative literature review

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 respirator...

Authors: Edward Baker, Andreas Xyrichis, Christine Norton, Philip Hopkins and Geraldine Lee