Articles

Defining major trauma: a Delphi study

Retrospective trauma scores are often used to categorise trauma, however, they have little utility in the prehospital or hyper-acute setting and do not define major trauma to non-specialists. This study employ...

Authors: Lee Thompson, Michael Hill, Fiona Lecky and Gary Shaw

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

Helicopter Emergency Medical Services (HEMS) respond to serious trauma and medical emergencies. Geographical disparity and the regionalisation of trauma systems can complicate accurate HEMS dispatch. We sought...

Authors: J. E. Griggs, J. W. Barrett, E. ter Avest, R. de Coverly, M. Nelson, J. Williams and R. M. Lyon

Severe traumatic brain injury and hypotension is a frequent and lethal combination in multiple trauma patients in mountain areas – an analysis of the prospective international Alpine Trauma Registry

Hypotension is associated with worse outcome in patients with traumatic brain injury (TBI) and maintaining a systolic blood pressure (SBP) ≥110 mmHg is recommended. The aim of this study was to assess the inci...

Authors: Simon Rauch, Matilde Marzolo, Tomas Dal Cappello, Mathias Ströhle, Peter Mair, Urs Pietsch, Hermann Brugger and Giacomo Strapazzon

Point-of-care ultrasound of the heart and lungs in patients with respiratory failure: a pragmatic randomized controlled multicenter trial

Point-of-care ultrasound is a focus oriented tool for differentiating among cardiopulmonary diseases. Its value in the hands of emergency physicians, with various ultrasound experience, remains uncertain. We t...

Authors: M. Riishede, A. T. Lassen, G. Baatrup, P. I. Pietersen, N. Jacobsen, K. N. Jeschke and C. B. Laursen

Which symptoms pose the highest risk in patients calling for an ambulance? A population-based cohort study from Denmark

Emergency medical service patients are a vulnerable population and the risk of mortality is considerable. In Denmark, healthcare professionals receive 112-emergency calls and assess the main reason for calling...

Authors: Stine Ibsen, Tim Alex Lindskou, Christian H. Nickel, Torben Kløjgård, Erika Frischknecht Christensen and Morten Breinholt Søvsø

Out-of-hospital resuscitation of a 3 month old boy presenting with recurrent ventricular fibrillation cardiac arrest: a case report

A 3 month old boy, with no known health conditions, suffered a sudden collapse at home. On first EMS arrival, ventricular fibrillation (VF) cardiac arrest was identified and resuscitation following UK national...

Authors: Peter Kingsley, Jonathan Merefield, Robert G. Walker, Fred W. Chapman and Mark Faulkner

Normalization of blood clotting characteristics using prothrombin complex concentrate, fibrinogen and FXIII in an albumin based fluid: experimental studies in thromboelastometry

Colloid fluids supplemented with adequate combinations of coagulation factor concentrates with the capability to restore coagulation could be a desirable future treatment component in massive transfusion.

Authors: Tobias Koller, Nadia Kinast, Andres Guilarte Castellanos, Sergio Perez Garcia, Pilar Paniagua Iglesias, Xavi León Vintro, Jose Mateo Arranz, Noelia Vilalta Seto, Ma. Victòria Moral García, Ana Belén Moreno-Castaño, Jose Aznar-Salatti, Gines Escolar Albaladejo and Maribel Diaz-Ricart

Falls in ED patients: do elderly patients on direct oral anticoagulants bleed less than those on vitamin K antagonists?

Falls from standing are common in the elderly and are associated with a significant risk of bleeding. We have compared the proportional incidence of bleeding complications in patients on either direct oral ant...

Authors: Martin Müller, Ioannis Chanias, Michael Nagler, Aristomenis K. Exadaktylos and Thomas C. Sauter

Trends in reasons for emergency calls during the COVID-19 crisis in the department of Gironde, France using artificial neural network for natural language classification

During periods such as the COVID-19 crisis, there is a need for responsive public health surveillance indicators in order to monitor both the epidemic growth and potential public health consequences of prevent...

Authors: Cédric Gil-Jardiné, Gabrielle Chenais, Catherine Pradeau, Eric Tentillier, Philippe Revel, Xavier Combes, Michel Galinski, Eric Tellier and Emmanuel Lagarde

Feasibility and accuracy of ED frailty identification in older trauma patients: a prospective multi-centre study

The burden of frailty on older people is identifiable by its adverse effect on mortality, morbidity and long term functional and health outcomes. In patients suffering from a traumatic injury there is increasi...

Authors: Heather Jarman, Robert Crouch, Mark Baxter, Chao Wang, George Peck, Dhanupriya Sivapathasuntharam, Cara Jennings and Elaine Cole

Cardiopulmonary resuscitation (CPR) training strategies in the times of COVID-19: a systematic literature review comparing different training methodologies

Traditional, instructor led, in-person training of CPR skills has become more challenging due to COVID-19 pandemic. We compared the learning outcomes of standard in-person CPR training (ST) with alternative me...

Authors: Daniyal Mansoor Ali, Butool Hisam, Natasha Shaukat, Noor Baig, Marcus Eng Hock Ong, Jonathan L. Epstein, Eric Goralnick, Paul D. Kivela, Bryan McNally and Junaid Razzak

Learning about stress from building, drilling and flying: a scoping review on team performance and stress in non-medical fields

Teamwork is essential in healthcare, but team performance tends to deteriorate in stressful situations. Further development of training and education for healthcare teams requires a more complete understanding...

Authors: Femke S. Dijkstra, Peter G. Renden, Martijn Meeter, Linda J. Schoonmade, Ralf Krage, Hans van Schuppen and Anne de la Croix

Impact of the SARS-COV-2 outbreak on epidemiology and management of major traumain France: a registry-based study (the COVITRAUMA study)

Emerging evidence suggests that the reallocation of health care resources during the COVID-19 pandemic negatively impacts health care system. This study describes the epidemiology and the outcome of major trau...

Authors: Jean-Denis Moyer, Arthur James, Clément Gakuba, Mathieu Boutonnet, Emeline Angles, Emmanuel Rozenberg, Jean Bardon, Thomas Clavier, Vincent Legros, Marie Werner, Quentin Mathais, Véronique Ramonda, Pierre Le Minh, Yann Berthelot, Clélia Colas, Julien Pottecher…

Introducing fairness in Norwegian air ambulance base location planning

A primary task of the Norwegian helicopter emergency medical services (HEMS) is to provide advanced medical care to the critical ill and injured outside of hospitals. Where HEMS bases are located, directly inf...

Authors: Caroline J. Jagtenberg, Maaike A. J. Vollebergh, Oddvar Uleberg and Jo Røislien

Analysis of tracheal intubation in out-of-hospital helicopter emergency medicine recorded by video laryngoscopy

Tracheal intubation remains the gold standard of airway management in emergency medicine and maximizing safety, intubation success, and especially first-pass intubation success (FPS) in these situations is imp...

Authors: Jürgen Knapp, Bettina Eberle, Michael Bernhard, Lorenz Theiler, Urs Pietsch and Roland Albrecht

Extracorporeal cardiopulmonary resuscitation for severe chloroquine intoxication in a child – a case report

Chloroquine use has increased worldwide recently in the setting of experimental treatment for the novel coronavirus disease (Covid-19). Nevertheless, in case of chloroquine intoxication, it can be life threate...

Authors: Thomas Ferry, Vivianne Amiet, Julia Natterer, Marie-Hélène Perez, Raymond Pfister, Sébastien Colombier and David Longchamp

Cerebral fat embolism after traumatic bone fractures: a structured literature review and analysis of published case reports

The incidence of cerebral fat embolism (CFE) ranges from 0.9–11%, with a mean mortality rate of around 10%. Although no univocal explanation has been identified for the resulting fat embolism syndrome (FES), t...

Authors: Luigi Vetrugno, Elena Bignami, Cristian Deana, Flavio Bassi, Maria Vargas, Maria Orsaria, Daniele Bagatto, Cristina Intermite, Francesco Meroi, Francesco Saglietti, Marco Sartori, Daniele Orso, Massimo Robiony and Tiziana Bove

Vacuum mattress or long spine board: which method of spinal stabilisation in trauma patients is more time consuming? A simulation study

Spinal stabilisation is recommended for prehospital trauma treatment. In Germany, vacuum mattresses are traditionally used for spinal stabilisation, whereas in anglo-american countries, long spine boards are p...

Authors: Roessler MS, M Riffelmann, N Kunze-Szikszay, M Lier, O Schmid, H Haus, S Schneider and Heuer JF

Medical dispatchers’ perception of the interaction with the caller during emergency calls - a qualitative study

Medical dispatching is a highly complex procedure and has an impact upon patient outcome. It includes call-taking and triage, prioritization of resources and the provision of guidance and instructions to calle...

Authors: Thea Palsgaard Møller, Hejdi Gamst Jensen, Søren Viereck, Freddy Lippert and Doris Østergaaard

Intraosseous versus intravenous vascular access during cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of observational studies

This study is aimed to investigate the association of intraosseous (IO) versus intravenous (IV) route during cardiopulmonary resuscitation (CPR) with outcomes after out-of-hospital cardiac arrest (OHCA).

Authors: Yu-Lin Hsieh, Meng-Che Wu, Jon Wolfshohl, James d’Etienne, Chien-Hua Huang, Tsung-Chien Lu, Edward Pei-Chuan Huang, Eric H. Chou, Chih-Hung Wang and Wen-Jone Chen

Geriatric screening, fall characteristics and 3- and 12 months adverse outcomes in older patients visiting the emergency department with a fall

Falls in older Emergency Department (ED) patients may indicate underlying frailty. Geriatric follow-up might help improve outcomes in addition to managing the direct cause and consequence of the fall. We aimed...

Authors: Laura C. Blomaard, Simon P. Mooijaart, Leonie J. van Meer, Julia Leander, Jacinta A. Lucke, Jelle de Gelder, Sander Anten, Jacobijn Gussekloo and Bas de Groot

Monitoring tissue oxygenation index using near‐infrared spectroscopy during pre‐hospital resuscitation among out‐of‐hospital cardiac arrest patients: a pilot study

Tissue oxygenation index (TOI) using the near infrared spectroscopy (NIRS) has been demonstrated as a useful indicator to predict return of spontaneous circulation (ROSC) among out-of-hospital cardiac arrest (...

Authors: Jumpei Tsukuda, Shigeki Fujitani, Mahbubur Rahman, Kenichiro Morisawa, Takeshi Kawaguchi and Yasuhiko Taira

Helicopter transport of critical care COVID-19 patients in the Netherlands: protection against COVID-19 exposure-a challenge to critical care retrieval personnel in a novel operation

During the Coronavirus Disease 2019 (COVID-19) outbreak in the Netherlands, the demand for intensive care beds exceeded availability within days. Initially, patients were redistributed regionally by ground tra...

Authors: Ed J. Spoelder, Marijn C. T. Tacken, Geert-Jan van Geffen and Cor Slagt

Quality of focused thoracic ultrasound performed by emergency medical technicians and paramedics in a prehospital setting: a feasibility study

In a prehospital setting, the severity of respiratory symptoms in patients calling for an ambulance differ. The initial evaluation, diagnosing, and thereby management can be challenging because respiratory sym...

Authors: Pia Iben Pietersen, Søren Mikkelsen, Annmarie T. Lassen, Simon Helmerik, Gitte Jørgensen, Giti Nadim, Helle Marie Christensen, Daniel Wittrock and Christian B. Laursen

Differences between manual CPR and corpuls cpr in regard to quality and outcome: study protocol of the comparing observational multi‐center prospective registry study on resuscitation (COMPRESS)

The effect of mechanical CPR is diversely described in the literature. Different mechanical CPR devices are available. The corpuls cpr is a new generation of piston-driven devices and was launched in 2015. The...

Authors: S. Seewald, S. Dopfer, J. Wnent, B. Jakisch, M. Heller, R. Lefering and JT Gräsner

Plasmatic and cell-based enhancement by microparticles originated from platelets and endothelial cells under simulated in vitro conditions of a dilutional coagulopathy

Aggressive fluid management and other external factors may lead to hypothermia, acidosis and hemodilution (defined as Lethal Triad, LT) contributing to a trauma-induced coagulopathy (TIC) that worsens patients...

Authors: Julia K. Böhm, Nadine Schäfer, Marc Maegele, Birgit Stümpges, Ursula Bauerfeind and Michael Caspers

Echocardiographic parameters during prolonged targeted temperature Management in out-of-hospital Cardiac Arrest Survivors to predict neurological outcome – a post-hoc analysis of the TTH48 trial

Transthoracic echocardiographic (TTE) indices of myocardial function among survivors of out-of-hospital cardiac arrest (OHCA) have been related to neurological outcome; however, results are inconsistent. We hy...

Authors: Thomas Hvid Jensen, Peter Juhl-Olsen, Bent Roni Ranghøj Nielsen, Johan Heiberg, Christophe Henri Valdemar Duez, Anni Nørgaard Jeppesen, Christian Alcaraz Frederiksen, Hans Kirkegaard and Anders Morten Grejs

Nasal nalbuphine analgesia in prehospital trauma managed by first-responder personnel on ski slopes in Switzerland: an observational cohort study

Pain is one of the major symptoms complained about by patients in the prehospital setting, especially in the case of trauma. When there is mountainous topography, as in Switzerland, there may be a time delay b...

Authors: Urs Pietsch, Yoël Berger, David Schurter, Lorenz Theiler, Volker Wenzel, Lorenz Meuli, Andreas Grünenfelder and Roland Albrecht

Is venous blood a more reliable description of acid-base state following simulated hypo- and hyperventilation?

ABGs are performed in acute conditions as the reference method for assessing the acid-base status of blood. Hyperventilation and breath-holding are common ventilatory changes that occur around the time of samp...

Authors: Lisha Shastri, Søren Kjærgaard, Peter S. Thyrrestrup, Stephen E. Rees and Lars P. Thomsen

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

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

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

A common definition should be used in future studies of NSC

Authors: Kirsi Kemp, Reija Mertanen, Leila Niemi-Murola, Lasse Lehtonen and Maaret Castrén

A pre-hospital risk score predicts critical illness in non-trauma patients transported by ambulance to a Dutch tertiary referral hospital

Early pre-hospital identification of critically ill patients reduces morbidity and mortality. To identify critically ill non-traumatic and non-cardiac arrest patients, a pre-hospital risk stratification tool w...

Authors: Lars I. Veldhuis, Markus W. Hollmann, Fabian O. Kooij and Milan L. Ridderikhof

Emergency physician’s dispatch by a paramedic-staffed emergency medical communication centre: sensitivity, specificity and search for a reference standard

Some emergency medical systems (EMS) use a dispatch centre where nurses or paramedics assess emergency calls and dispatch ambulances. Paramedics may also provide the first tier of care “in the field”, with the...

Authors: Victor Nathan Chappuis, Hélène Deham, Philippe Cottet, Birgit Andrea Gartner, François Pierre Sarasin, Marc Niquille, Laurent Suppan and Robert Larribau

Effects of COVID-19 on in-hospital cardiac arrest: incidence, causes, and outcome – a retrospective cohort study

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), an emerging virus, has caused a global pandemic. Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has led to high hospitalization rates w...

Authors: Kevin Roedl, Gerold Söffker, Dominik Fischer, Jakob Müller, Dirk Westermann, Malte Issleib, Stefan Kluge and Dominik Jarczak

Smartphone-based dispatch of community first responders to out-of-hospital cardiac arrest - statements from an international consensus conference

Over the past decade Smartphone-based activation (SBA) of Community First Responders (CFR) to out-of-hospital cardiac arrests (OHCA) has gained much attention and popularity throughout Europe. Various programm...

Authors: Camilla Metelmann, Bibiana Metelmann, Dorothea Kohnen, Peter Brinkrolf, Linn Andelius, Bernd W. Böttiger, Roman Burkart, Klaus Hahnenkamp, Mario Krammel, Tore Marks, Michael P. Müller, Stefan Prasse, Remy Stieglis, Bernd Strickmann and Karl Christian Thies

Analgesia in adult trauma patients in physician-staffed Austrian helicopter rescue: a 12-year registry analysis

Sufficient analgesia is an obligation, but oligoanalgesia (NRS> 3) is frequently observed prehospitally. Potent analgesics may cause severe adverse events. Thus, analgesia in the helicopter emergency medical s...

Authors: Christopher Rugg, Simon Woyke, Wolfgang Voelckel, Peter Paal and Mathias Ströhle

Virtual reality as a teaching method for resuscitation training in undergraduate first year medical students: a randomized controlled trial

Virtual reality is an innovative technology for medical education associated with high empirical realism.

Authors: Malte Issleib, Alina Kromer, Hans O. Pinnschmidt, Christoph Süss-Havemann and Jens C. Kubitz

The impact of age and receipt antihypertensives to systolic blood pressure and shock index at injury scene and in the emergency department to predict massive transfusion in trauma patients

Systolic blood pressure (SBP) and shock index (SI) are accurate indicators of hemodynamic instability and the need for transfusion in trauma patients. We aimed to determine whether the utility and cutoff point...

Authors: Se Jin Park, Mi Jin Lee, Changho Kim, Haewon Jung, Seong Hun Kim, Wooyoung Nho, Kang Suk Seo, Jungbae Park, Hyun Wook Ryoo, Jae Yun Ahn, Sungbae Moon, Jae Wan Cho and Shin-ah Son

Consensus on research priorities for Essex & Herts Air Ambulance: a Delphi study

Consensus methods such as the Delphi technique have been used widely for research priority setting in health care. Within pre-hospital emergency medicine, such approaches have helped to establish national and ...

Authors: Sarah McLachlan and Hilary Bungay

Association between the body mass index and outcomes of patients resuscitated from out-of-hospital cardiac arrest: a prospective multicentre registry study

The effects of the body mass index (BMI) on outcomes of patients resuscitated from cardiac arrest are controversial. Therefore, the current study investigated the association between the BMI and the favourable...

Authors: Heekyung Lee, Jaehoon Oh, Hyunggoo Kang, Tae Ho Lim, Byuk Sung Ko, Hyuk Joong Choi, Seung Min Park, You Hwan Jo, Jong Suk Lee, Yoo Seok Park, Young-Hoon Yoon, Su Jin Kim and Young-Gi Min

Early hemodynamic assessment using NICOM in patients at risk of developing Sepsis immediately after emergency department triage

One factor leading to the high mortality rate seen in sepsis is the subtle, dynamic nature of the disease, which can lead to delayed detection and under-resuscitation. This study investigated whether serial he...

Authors: Steve B. Chukwulebe, David F. Gaieski, Abhishek Bhardwaj, Lakeisha Mulugeta-Gordon, Frances S. Shofer and Anthony J. Dean

Early posttraumatic stress symptoms and levels of distress in trauma patients treated in the resuscitation room: an exploratory study

The aim of the present study was to investigate the incidence of psychological distress and posttraumatic stress symptoms in trauma patients who have been recruited from the resuscitation room. Further, we wan...

Authors: Iris Reiner, Manfred E. Beutel, Philipp Winter, Pol M. Rommens and Sebastian Kuhn

Patient handover between ambulance crew and healthcare professionals in Icelandic emergency departments: a qualitative study

Ambulance services play an important role in the healthcare system when it comes to handling accidents or acute illnesses outside of hospitals. At the time of patient handover from emergency medical technician...

Authors: Sveinbjörn Dúason, Björn Gunnarsson and Margrét Hrönn Svavarsdóttir

Conducting a conventional multi-casualty incident in COVID-19 personal protective equipment - a semi-structured interview

The risk of COVID-19 transmission to healthcare professionals is likely to continue for the foreseeable future. The wearing of personal protective equipment (PPE) presents a number of potential challenges to r...

Authors: James Raitt, Ben Watts, Jaspreet Rayet, Mark Hodkinson and David Zideman

External validation of multimodal termination of resuscitation rules for out-of-hospital cardiac arrest patients in the COVID-19 era

Futile resuscitation for out-of-hospital cardiac arrest (OHCA) patients in the coronavirus disease (COVID)-19 era can lead to risk of disease transmission and unnecessary transport. Various existing basic or a...

Authors: Haewon Jung, Mi Jin Lee, Jae Wan Cho, Sang Hun Lee, Suk Hee Lee, You Ho Mun, Han-sol Chung, Yang Hun Kim, Gyun Moo Kim, Sin-youl Park, Jae Cheon Jeon and Changho Kim

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

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