Articles

A validity study of the rapid emergency Triage and treatment system for children

The Scandinavian Rapid Emergency Triage and Treatment System-pediatric (RETTS-p) is a reliable triage system that includes both assessment of vital parameters and a systematic approach to history and symptoms....

Authors: Siv Steinsmo Ødegård, Thuy Tran, Lars E. Næss-Pleym, Kari Risnes and Henrik Døllner

A comparison of the demographics, injury patterns and outcome data for patients injured in motor vehicle collisions who are trapped compared to those patients who are not trapped

Motor vehicle collisions (MVCs) are a common cause of major trauma and death. Following an MVC, up to 40% of patients will be trapped in their vehicle. Extrication methods are focused on the prevention of seco...

Authors: Tim Nutbeam, Rob Fenwick, Jason Smith, Omar Bouamra, Lee Wallis and Willem Stassen

Pre-hospital critical care management of severe hypoxemia in victims of Covid-19: a case series

Despite critical hypoxemia, Covid-19 patients may present without proportional signs of respiratory distress. We report three patients with critical respiratory failure due to Covid-19, in which all presented ...

Authors: Jens Otto Mæhlen, Roger Mikalsen, Hans Julius Heimdal, Marius Rehn, Jostein S. Hagemo and William Ottestad

The accuracy of initial diagnoses in coma: an observational study in 835 patients with non-traumatic disorder of consciousness

Management of patients with coma of unknown etiology (CUE) is a major challenge in most emergency departments (EDs). CUE is associated with a high mortality and a wide variety of pathologies that require diffe...

Authors: Maximilian Lutz, Martin Möckel, Tobias Lindner, Christoph J. Ploner, Mischa Braun and Wolf Ulrich Schmidt

Multitasking behaviors and provider outcomes in emergency department physicians: two consecutive, observational and multi-source studies

Multitasking is a key skill for emergency department (ED) providers. Yet, potentially beneficial or debilitating effects for provider functioning and cognition are underexplored. We therefore aimed to investig...

Authors: Tobias Augenstein, Anna Schneider, Markus Wehler and Matthias Weigl

Why do infants need out-of-hospital emergency medical services? A retrospective, population-based study

The challenges encountered in emergency medical services (EMS) contacts with children are likely most pronounced in infants, but little is known about their out-of-hospital care. Our primary aim was to describ...

Authors: Jelena Oulasvirta, Heini Harve-Rytsälä, Mitja Lääperi, Markku Kuisma and Heli Salmi

Serum D-dimer level as a biomarker for identifying patients with isolated injury to prevent unnecessary whole-body computed tomography in blunt trauma care

Unnecessary whole-body computed tomography (CT) may lead to excess radiation exposure. Serum D-dimer levels have been reported to correlate with injury severity. We examined the predictive value of serum D-dim...

Authors: Rakuhei Nakama, Ryo Yamamoto, Yoshimitsu Izawa, Keiichi Tanimura and Takashi Mato

Injuries, treatment, and impairment caused by different types of fireworks; results of a 10 year multicenter retrospective cohort study

The primary aim of this study was to evaluate the number of patients reported to a hospital with injuries from consumer fireworks in the months December–January in the past 10 years, and to describe the associ...

Authors: Daan T. Van Yperen, Esther M. M. Van Lieshout, J. Niels Dijkshoorn, Cornelis H. Van der Vlies and Michael H. J. Verhofstad

Apnoeic oxygenation for emergency anaesthesia of pre-hospital trauma patients

Efficient and timely airway management is universally recognised as a priority for major trauma patients, a proportion of whom require emergency intubation in the pre-hospital setting. Adverse events occur mor...

Authors: Kate Crewdson, Ainsley Heywoth, Marius Rehn, Samy Sadek and David Lockey

Physician-led prehospital management is associated with reduced mortality in severe blunt trauma patients: a retrospective analysis of the Japanese nationwide trauma registry

Although the results of previous studies suggested the effectiveness of physician-led prehospital trauma management, it has been uncertain because of the limited number of high-quality studies. Furthermore, th...

Authors: Akira Endo, Mitsuaki Kojima, Saya Uchiyama, Atsushi Shiraishi and Yasuhiro Otomo

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): update and insights into current practices and future directions for research and implementation

In this review, we assess the state of Resuscitative Endovascular Occlusion of the Aorta (REBOA) today with respect to out-of-hospital (OOH) vs. inhospital (H) use in blunt and penetrating trauma, as well as d...

Authors: Marianne A. Thrailkill, Kevin H. Gladin, Catherine R. Thorpe, Teryn R. Roberts, Jae H. Choi, Kevin K. Chung, Corina N. Necsoiu, Todd E. Rasmussen, Leopoldo C. Cancio and Andriy I. Batchinsky

Predictors of recognition of out of hospital cardiac arrest by emergency medical services call handlers in England: a mixed methods diagnostic accuracy study

The aim of this study was to identify key indicator symptoms and patient factors associated with correct out of hospital cardiac arrest (OHCA) dispatch allocation. In previous studies, from 3% to 62% of OHCAs ...

Authors: Caroline L. Watkins, Stephanie P. Jones, Margaret A. Hurley, Valerio Benedetto, Christopher I. Price, Christopher J. Sutton, Tom Quinn, Munirah Bangee, Brigit Chesworth, Colette Miller, Dawn Doran, Aloysius Niroshan Siriwardena and Josephine M. E. Gibson

Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: usefulness for tranexamic acid treatment criteria

Tranexamic acid reduces surgical blood loss and reduces deaths from bleeding in trauma patients. Tranexamic acid must be given urgently, preferably by paramedics at the scene of the injury or in the ambulance....

Authors: Francois-Xavier Ageron, Timothy J. Coats, Vincent Darioli and Ian Roberts

Hospital-level intracranial pressure monitoring utilization and functional outcome in severe traumatic brain injury: a post hoc analysis of prospective multicenter observational study

Several observational studies have shown that hospital-level intracranial pressure (ICP) monitoring utilization varies considerably in patients with severe traumatic brain injury (TBI). However, the relationsh...

Authors: Tomoya Okazaki, Kenya Kawakita and Yasuhiro Kuroda

Alternatives to direct emergency department conveyance of ambulance patients: a scoping review of the evidence

The role of ambulance services is shifting, due in part to more intermediate, non-urgent patients who do not require direct emergency department conveyance, yet who cannot be safely left at home alone. Evidenc...

Authors: Joanna M. Blodgett, Duncan J. Robertson, Elspeth Pennington, David Ratcliffe and Kenneth Rockwood

Prehospital identification of Covid-19: an observational study

The novel coronavirus disease 2019 (Covid-19) pandemic has affected prehospital care systems across the world, but the prehospital presentation of affected patients and the extent to which prehospital care pro...

Authors: Douglas Spangler, Hans Blomberg and David Smekal

The protective effects of phosphodiesterase-5 inhibitor, sildenafil on post-resuscitation cardiac dysfunction of cardiac arrest: by regulating the miR-155-5p and miR-145-5p

MiRNA-155 and miRNA-145 have been demonstrated to function as a key regulator in the development of the cardiovascular system. Recent experimental and clinical studies have indicated the cardioprotective role ...

Authors: Yong He, Guoxing Wang, Chuang Li, Yuxing Wang and Qian Zhang

Survival among patients with severe high cervical spine injuries – a TraumaRegister DGU® database study

Trauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the maj...

Authors: O. Kamp, O. Jansen, R. Lefering, M. Aach, C. Waydhas, M. Dudda, T. A. Schildhauer and U. Hamsen

Assessment of changes in cardiopulmonary resuscitation practices and outcomes on 1005 victims of out-of-hospital cardiac arrest during the COVID-19 outbreak: registry-based study

The COVID-19 outbreak requires a permanent adaptation of practices. Cardiopulmonary resuscitation (CPR) is also involved and we evaluated these changes in the management of out-of-hospital cardiac arrest (OHCA).

Authors: Valentine Baert, Deborah Jaeger, Hervé Hubert, Jean-Baptiste Lascarrou, Guillaume Debaty, Tahar Chouihed and François Javaudin

A conceptual framework for Emergency department design in a pandemic

The current COVID-19 pandemic is highlighting gaps around the world in the design and workflow of Emergency Departments (ED). These gaps have an impact on both patient care and staff safety and represent a ris...

Authors: Gayathri Devi Nadarajan, Eunizar Omar, Benjamin S. Abella, Pei Shan Hoe, Sang Do Shin, Matthew Huei-Ming Ma and Marcus Eng Hock Ong

Multiple trauma management in mountain environments - a scoping review

Multiple trauma in mountain environments may be associated with increased morbidity and mortality compared to urban environments.

Authors: G. Sumann, D. Moens, B. Brink, M. Brodmann Maeder, M. Greene, M. Jacob, P. Koirala, K. Zafren, M. Ayala, M. Musi, K. Oshiro, A. Sheets, G. Strapazzon, D. Macias and P. Paal

Endotracheal intubation to reduce aspiration events in acutely comatose patients: a systematic review

It is customary to believe that a patient with a Glasgow Coma Scale (GCS) score less than or equal to 8 should be intubated to avoid aspiration. We conducted a systematic review to establish if patients with G...

Authors: Daniele Orso, Luigi Vetrugno, Nicola Federici, Natascia D’Andrea and Tiziana Bove

Major incident preparedness: a curriculum and workplace necessity

Major incidents are defined as: An event or situation with a range of serious consequences, which require special arrangements to be implemented by one, or more emergency responder agency. The ability for a he...

Authors: Dominic Hampson

The effect of national lockdown due to COVID-19 on emergency department visits

COVID-19 outbreak lead to nationwide lockdown in Finland on the March 16th, 2020. Previous data regarding to the patient load in the emergency departments during pandemics is scarce. Our aim is to describe the...

Authors: Ilari Kuitunen, Ville T. Ponkilainen, Antti P. Launonen, Aleksi Reito, Teemu P. Hevonkorpi, Juha Paloneva and Ville M. Mattila

Development of machine learning models to predict RT-PCR results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with influenza-like symptoms using only basic clinical data

Reverse Transcription-Polymerase Chain Reaction (RT-PCR) for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) diagnosis currently requires quite a long time span. A quicker and more efficient diagn...

Authors: Thomas Langer, Martina Favarato, Riccardo Giudici, Gabriele Bassi, Roberta Garberi, Fabiana Villa, Hedwige Gay, Anna Zeduri, Sara Bragagnolo, Alberto Molteni, Andrea Beretta, Matteo Corradin, Mauro Moreno, Chiara Vismara, Carlo Federico Perno, Massimo Buscema…

Mechanical ventilation of patients in helicopter emergency medical service transport: an international survey

Mechanical ventilation in helicopter emergency medical service (HEMS) environments is a procedure which carries a significant risk of complications. Limited data on the quality and performance of mechanical ve...

Authors: Peter Hilbert-Carius, Manuel F. Struck, Veronika Hofer, Jochen Hinkelbein, Leif Rognås, Jörn Adler, Michael D. Christian, Thomas Wurmb, Michael Bernhard and Björn Hossfeld

The use of HEAVEN criteria to predict difficult laryngeal view and intubation failure with direct and video laryngoscopy

Authors: Ryan D. Henschell and Paul K. Miller

How should nonspecific complaints be defined? Comment to: “nonspecific complaints (NSCs) in the emergency department”

Authors: Roland Bingisser and Christian H. Nickel

ILCOR’s revised Covid-19 defibrillation recommendation requires a new approach to training

In-hospital resuscitation practices have changed by necessity in the Covid-19 era, principally due to precautions intended to protect caregivers from infection. This has resulted in serious delays in resuscita...

Authors: John A. Stewart

Cardiopulmonary resuscitation (CPR) during spaceflight - a guideline for CPR in microgravity from the German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG)

With the “Artemis”-mission mankind will return to the Moon by 2024. Prolonged periods in space will not only present physical and psychological challenges to the astronauts, but also pose risks concerning the ...

Authors: Jochen Hinkelbein, Steffen Kerkhoff, Christoph Adler, Anton Ahlbäck, Stefan Braunecker, Daniel Burgard, Fabrizio Cirillo, Edoardo De Robertis, Eckard Glaser, Theresa K. Haidl, Pete Hodkinson, Ivan Zefiro Iovino, Stefanie Jansen, Kolaparambil Varghese Lydia Johnson, Saskia Jünger, Matthieu Komorowski…

Emergency department crowding and hospital transformation during COVID-19, a retrospective, descriptive study of a university hospital in Stockholm, Sweden

COVID-19 presents challenges to the emergency care system that could lead to emergency department (ED) crowding. The Huddinge site at the Karolinska university hospital (KH) responded through a rapid transform...

Authors: Björn af Ugglas, Niclas Skyttberg, Andreas Wladis, Therese Djärv and Martin J. Holzmann

Exploiting an early warning Nomogram for predicting the risk of ICU admission in patients with COVID-19: a multi-center study in China

Novel coronavirus disease 2019 (COVID-19) is a global public health emergency. Here, we developed and validated a practical model based on the data from a multi-center cohort in China for early identification ...

Authors: Yiwu Zhou, Yanqi He, Huan Yang, He Yu, Ting Wang, Zhu Chen, Rong Yao and Zongan Liang

Correction to: Is prehospital use of active external warming dangerous for patients with accidental hypothermia: a systematic review

An amendment to this paper has been published and can be accessed via the original article.

Authors: Sigurd Mydske and Øyvind Thomassen

Resilience in a prehospital setting - a new focus for future research?

Handling and initiating of treatment in a prehospital setting are complex processes that involve many treatment options and include several parts of the chain of survival. Capacity to adapt to unexpected chang...

Authors: Elisabeth Jeppesen and Siri Wiig

Description of Emergency Medical Services, treatment of cardiac arrest patients and cardiac arrest registries in Europe

Variation in the incidence, survival rate and factors associated with survival after cardiac arrest in Europe is reported. Some studies have tried to fill the knowledge gap regarding the epidemiology of out-of...

Authors: Ingvild B. M. Tjelmeland, Siobhan Masterson, Johan Herlitz, Jan Wnent, Leo Bossaert, Fernando Rosell-Ortiz, Kristin Alm-Kruse, Berthold Bein, Gisela Lilja and Jan-Thorsten Gräsner

Can non-physician advanced retrieval practitioners (ARP) acquire and interpret diagnostic views of the lungs with sufficient quality to aid in the diagnosis of pneumothorax in the pre-hospital and retrieval environment?

As an adjunct to physical examination, ultrasound is a potentially attractive option for diagnosing pneumothoraces in the pre-hospital and retrieval environment – and could confer a benefit to patient safety. ...

Authors: James Ronaldson, Christopher E. J. Moultrie, Alasdair R. Corfield and Evelyn McElhinney

Out-of-hospital cardiac arrest patients with an initial non-shockable rhythm could be candidates for extracorporeal cardiopulmonary resuscitation: a retrospective study

Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising treatment for refractory out-of-hospital cardiac arrest (OHCA). Most studies evaluating the effectiveness of ECPR include patients with an ini...

Authors: Atsunori Tanimoto, Kazuhiro Sugiyama, Maki Tanabe, Kanta Kitagawa, Ayumi Kawakami and Yuichi Hamabe

Mortality and quality of care in Nordic physician-staffed emergency medical services

Quality indicators (QI) for physician staffed emergency medical services (P-EMS) are necessary to improve service quality. Mortality can be considered the ultimate outcome QI. The process quality of care in P-...

Authors: Helge Haugland, Anna Olkinuora, Leif Rognås, David Ohlén and Andreas Krüger

Oxygenation strategies prior to and during prehospital emergency anaesthesia in UK HEMS practice (PREOXY survey)

Maintaining effective oxygenation throughout the process of Pre-Hospital Emergency Anaesthesia (PHEA) is critical. There are multiple strategies available to clinicians to oxygenate patients both prior to and ...

Authors: Adam J. Boulton, Amar Mashru and Richard Lyon

Artificial intelligence algorithm for predicting cardiac arrest using electrocardiography

In-hospital cardiac arrest is a major burden in health care. Although several track-and-trigger systems are used to predict cardiac arrest, they often have unsatisfactory performances. We hypothesized that a d...

Authors: Joon-myoung Kwon, Kyung-Hee Kim, Ki-Hyun Jeon, Soo Youn Lee, Jinsik Park and Byung-Hee Oh

Burn care: before the burn center

Authors: David J. Dries

Establishment of an extracorporeal cardio-pulmonary resuscitation program in Berlin – outcomes of 254 patients with refractory circulatory arrest

Optimal management of out of hospital circulatory arrest (OHCA) remains challenging, in particular in patients who do not develop rapid return of spontaneous circulation (ROSC). Extracorporeal cardiopulmonary ...

Authors: Jens Nee, Roland Koerner, Daniel Zickler, Tim Schroeder, Philipp Enghard, Lutz Nibbe, Dietrich Hasper, Robert Buder, Christoph Leithner, Christoph J. Ploner, Kai-Uwe Eckardt, Christian Storm and Jan M. Kruse

Prediction of mortality in critically-ill elderly trauma patients: a single centre retrospective observational study and comparison of the performance of trauma scores

Trauma in the elderly (≥ 65 years) population is increasing. This study compares the performance of trauma scoring systems in predicting 30-day mortality among the traumatised elderly patients admitted to the ...

Authors: Rebecca Egglestone, David Sparkes and Ahilanandan Dushianthan

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services—particularl...

Authors: Peter Hilbert-Carius, Jörg Braun, Fikri Abu-Zidan, Jörn Adler, Jürgen Knapp, Didier Dandrifosse, Désirée Braun, Urs Pietsch, Patrick Adamczuk, Leif Rognås and Roland Albrecht

Real-time AI prediction for major adverse cardiac events in emergency department patients with chest pain

A big-data-driven and artificial intelligence (AI) with machine learning (ML) approach has never been integrated with the hospital information system (HIS) for predicting major adverse cardiac events (MACE) in...

Authors: Pei-I Zhang, Chien-Chin Hsu, Yuan Kao, Chia-Jung Chen, Ya-Wei Kuo, Shu-Lien Hsu, Tzu-Lan Liu, Hung-Jung Lin, Jhi-Joung Wang, Chung-Feng Liu and Chien-Cheng Huang

Massive hemothorax due to bleeding from thoracic spinal fractures: a case series and systematic review

Massive hemothorax secondary to thoracic spinal fractures is rare, and its clinical characteristics, treatment, and prognosis are unknown. We present two cases of thoracic spinal fracture-induced massive hemot...

Authors: Kohei Ninomiya, Akira Kuriyama and Hayaki Uchino

Consistency and variability in human performance during simulate infant CPR: a reliability study

Positive outcomes from infant cardiac arrest depend on the effective delivery of resuscitation techniques, including good quality infant cardiopulmonary resuscitation (iCPR) However, it has been established th...

Authors: Debora Almeida, Carol Clark, Michael Jones, Phillip McConnell and Jonathan Williams

Evolution and current state of global research on paediatric resuscitation: a systematic scientometric analysis

Paediatric resuscitation is rare but potentially associated with maximal lifetime reduction. Notably, several nations experience high infant mortality rates even today. To improve clinical outcomes and promote...

Authors: Sean S. Scholz, Rainer Borgstedt, Leoni C. Menzel, Sebastian Rehberg and Gerrit Jansen

Intubation during a medevac flight: safety and effect on total prehospital time in the helicopter emergency medical service system

The Helicopter Emergency Medical Service (HEMS) commonly intubates patients who require advanced airway support prior to takeoff. In-flight intubation (IFI) is avoided because it is considered difficult due to...

Authors: Hiroki Maeyama, Hiromichi Naito, Francis X. Guyette, Takashi Yorifuji, Yuki Banshotani, Daisaku Matsui, Tetsuya Yumoto, Atsunori Nakao and Makoto Kobayashi

High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study

To evaluate the associations between glycated hemoglobin (HbA1c) at admission and 6-month mortality and outcomes after out-of-hospital cardiac arrest (OHCA) treated by hypothermic targeted temperature manageme...

Authors: Junhaeng Lee, Joo Suk Oh, Jong Ho Zhu, Sungyoup Hong, Sang Hyun Park, Ji Hoon Kim, Hyungsoo Kim, Mingu Seo, Kiwook Kim, Doo Hyo Lee, Hyun Ho Jung, Jungtaek Park, Young Min Oh, Semin Choi and Kyoung Ho Choi