Articles

A retrospective register study comparing fibrinogen treated trauma patients with an injury severity score matched control group

Fibrinogen concentrate (FC) is frequently used to treat bleeding trauma patients, although the clinical effects are not well known. In this study we describe demographic and clinical outcome data in a cohort o...

Authors: Lou M. Almskog, Ulf Hammar, Agneta Wikman, Anders Östlund, Jonas Svensson, Michael Wanecek and Anna Ågren

Developing a tool for measuring the disaster resilience of healthcare rescuers: a modified Delphi study

Disaster resilience is an essential personal characteristics of health rescue workers to respond to disasters in an effective manner, and maintain a state of adaptation after deployment. It is essential for di...

Authors: Xiaorong MAO, Alice Yuen LOKE and Xiuying HU

Associations of therapeutic hypothermia with clinical outcomes in patients receiving ECPR after cardiac arrest: systematic review with meta-analysis

Therapeutic hypothermia has been recommended for eligible patients after cardiac arrest (CA) in order to improve outcomes. Up to now, several comparative observational studies have evaluated the combined use o...

Authors: Xi Chen, Zhen Zhen, Jia Na, Qin Wang, Lu Gao and Yue Yuan

Clinical guided computer tomography decisions are advocated in potentially severely injured trauma patients: a one-year audit in a level 1 trauma Centre with long pre-hospital times

The International Commission on Radiological Protection’s (ICRP) justification principles state that an examination is justified if the potential benefit outweighs the risk for radiation harm. Computer tomogra...

Authors: Anna Bågenholm, Trond Dehli, Stig Eggen Hermansen, Kristian Bartnes, Marthe Larsen and Tor Ingebrigtsen

Spontaneous trigger words associated with confirmed out-of-hospital cardiac arrest: a descriptive pilot study of emergency calls

According to the International Liaison Committee on Resuscitation (ILCOR), the trigger words used by callers that are associated with cardiac arrest constitute a scientific knowledge gap. This study was design...

Authors: Joonas Tamminen, Erik Lydén, Jan Kurki, Heini Huhtala, Antti Kämäräinen and Sanna Hoppu

Impact of a goal-directed factor-based coagulation management on thromboembolic events following major trauma

A factor-based coagulation management following major trauma is recommended as standard of care by the European Trauma Treatment Guidelines. However, concerns about the thromboembolic risk of this approach are...

Authors: Anais L. Stein, Julian Rössler, Julia Braun, Kai Sprengel, Patrick E. Beeler, Donat R. Spahn, Alexander Kaserer and Philipp Stein

Open-chest cardiopulmonary resuscitation versus closed-chest cardiopulmonary resuscitation in patients with cardiac arrest: a systematic review and meta-analysis

Cardiopulmonary resuscitation is the most urgent and critical step in the rescue of patients with cardiac arrest. However, only about 10% of patients with out-of-hospital cardiac arrest survive to discharge. S...

Authors: Mao Wang, Xiaoguang Lu, Ping Gong, Yilong Zhong, Dianbo Gong and Yi Song

Impact of gender on post- traumatic intensive care and outcomes

Several reports indicate gender disparities in health care provision. There is a well-documented male patient dominance in intensive care unit (ICU) admittance. It is not established if this difference reflect...

Authors: Emma Larsson, Ann-Charlotte Lindström, Mikael Eriksson and Anders Oldner

Development, validation and assessment of the test on knowledge about basic life support and use of automated external defibrillator among schoolchildren

Educating lay public can significantly strengthen the Chain of Survival after out of hospital cardiac arrest. Schoolchildren are an accessible population for learning basic life support (BLS) and use of an aut...

Authors: Vesna Borovnik Lesjak, Andrej Šorgo and Matej Strnad

Intra-patient potassium variability after hypothermic cardiac arrest: a multicentre, prospective study

To date, the decision to set up therapeutic extra-corporeal life support (ECLS) in hypothermia-related cardiac arrest is based on the potassium value only. However, no information is available about how the an...

Authors: M. Pasquier, M. Blancher, S. Buse, B. Boussat, G. Debaty, M. Kirsch, M. de Riedmatten, P. Schoettker, T. Annecke and P. Bouzat

First-response treatment after out-of-hospital cardiac arrest: a survey of current practices across 29 countries in Europe

In Europe, survival rates after out-of-hospital cardiac arrest (OHCA) vary widely. Presence/absence and differences in implementation of systems dispatching First Responders (FR) in order to arrive before Emer...

Authors: Iris Oving, Siobhan Masterson, Ingvild B.M. Tjelmeland, Martin Jonsson, Federico Semeraro, Mattias Ringh, Anatolij Truhlar, Diana Cimpoesu, Fredrik Folke, Stefanie G. Beesems, Rudolph W. Koster, Hanno L. Tan and Marieke T. Blom

National early warning score (NEWS) and the new alternative SpO₂ scale during rapid response team reviews: a prospective observational study

The national early warning score (NEWS) enables early detection of in-hospital patient deterioration and timely activation of hospital’s rapid response team (RRT). NEWS was updated in 2017 to include a separat...

Authors: Joonas Tirkkonen, Sari Karlsson and Markus B. Skrifvars

The cost-effectiveness of upfront point-of-care testing in the emergency department: a secondary analysis of a randomised, controlled trial

Time-saving is constantly sought after in the Emergency Department (ED), and Point-of-Care (POC) testing has been shown to be an effective time-saving intervention. However, when direct costs are compared, the...

Authors: Lara Nicole Goldstein, Mike Wells and Craig Vincent-Lambert

Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: retrospective analysis of prospectively collected prehospital data

The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone adminis...

Authors: Dong Keon Lee, Yu Jin Kim, Giwoon Kim, Choung Ah. Lee, Hyung Jun Moon, Jaehoon Oh, Hae Chul Yang, Han Joo Choi, Young Taeck Oh and Seung Min Park

Nonoperative management of splenic injury in closely monitored patients with reduced consciousness is safe and feasible

Treatment of blunt splenic injury has changed over the past decades. Nonoperative management (NOM) is the treatment of choice. Adequate patient selection is a prerequisite for successful NOM. Impaired mental s...

Authors: Michel Teuben, Roy Spijkerman, Taco Blokhuis, Roman Pfeifer, Henrik Teuber, Hans-Christoph Pape and Luke Leenen

Comment on epinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study

The aim of this Letter to the Editor was to report some important biases in a recently published Article. We agreed with the notion by Yamamoto et al. that the effects of epinephrine regarding was limited with...

Authors: Makoto Aoki and Toshikazu Abe

Outcome, quality of life and direct costs after out-of-hospital cardiac arrest in an urban region of Switzerland

Considering the significant morbidity and mortality of out-of-hospital cardiac arrest, only little data on survival or quality of life after successful resuscitation is available in Europe. Additionally, econo...

Authors: Raphael Ruch, Laura Stoessel, Philipp Stein, Michael Thomas Ganter and Daniel Anthony Button

Impact of rewarming rate on the mortality of patients with accidental hypothermia: analysis of data from the J-Point registry

Accidental hypothermia (AH) is defined as an involuntary decrease in core body temperature to < 35 °C. The management of AH has been progressing over the last few decades, and numerous techniques for rewarming...

Authors: Makoto Watanabe, Tasuku Matsuyama, Sachiko Morita, Naoki Ehara, Nobuyoshi Miyamae, Yohei Okada, Takaaki Jo, Yasuyuki Sumida, Nobunaga Okada, Masahiro Nozawa, Ayumu Tsuruoka, Yoshihiro Fujimoto, Yoshiki Okumura, Tetsuhisa Kitamura and Bon Ohta

Regional hypothermia attenuates secondary-injury caused by time-out application of tourniquets following limb fragments injury combined with hemorrhagic shock

Tourniquet is the most widely used and effective first-aid equipment for controlling hemorrhage of injured limb in battlefield. However, time-out application of tourniquets leads to ischemic-necrosis of skelet...

Authors: Changmei Weng, Kai Lan, Tao Li, Liangchao Zhang, Jianmin Wang and Xinan Lai

Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study

Severe accidental hypothermia (AH) is life threatening. Thus, prognostic prediction in AH is essential to rapidly initiate intensive care. Several studies on prognostic factors for AH are known, but none have ...

Authors: Kenji Kandori, Yohei Okada, Tasuku Matsuyama, Sachiko Morita, Naoki Ehara, Nobuhiro Miyamae, Takaaki Jo, Yasuyuki Sumida, Nobunaga Okada, Makoto Watanabe, Masahiro Nozawa, Ayumu Tsuruoka, Yoshihiro Fujimoto, Yoshiki Okumura, Tetsuhisa Kitamura and Ryoji Iiduka

Characteristics of patients treated by the Danish Helicopter Emergency Medical Service from 2014-2018: a nationwide population-based study

A national Helicopter Emergency Medical Service (HEMS) was introduced in Denmark in 2014 to ensure the availability of physician-led critical care for all patients regardless of location.

Authors: Karen Alstrup, Thea Palsgaard Møller, Lars Knudsen, Troels Martin Hansen, Jens Aage Kølsen Petersen, Leif Rognås and Charlotte Barfod

Causes of brain dysfunction in acute coma: a cohort study of 1027 patients in the emergency department

Coma of unknown etiology (CUE) is a major challenge in emergency medicine. CUE is caused by a wide variety of pathologies that require immediate and targeted treatment. However, there is little empirical data ...

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

The Danish prehospital emergency healthcare system and research possibilities

The emergency medical healthcare system outside hospital varies greatly across the globe - even within the western world. Within the last ten years, the demand for emergency medical service systems has increas...

Authors: Tim Alex Lindskou, Søren Mikkelsen, Erika Frischknecht Christensen, Poul Anders Hansen, Gitte Jørgensen, Ole Mazur Hendriksen, Hans Kirkegaard, Peter Anthony Berlac and Morten Breinholt Søvsø

Application of NICE or SNC guidelines may reduce the need for computerized tomographies in patients with mild traumatic brain injury: a retrospective chart review and theoretical application of five guidelines

Traumatic brain injuries continue to be a significant cause of mortality and morbidity worldwide. Most traumatic brain injuries are classified as mild, with a low but not negligible risk of intracranial hemorr...

Authors: Sebastian Svensson, Tomas Vedin, Linus Clausen, Per-Anders Larsson and Marcus Edelhamre

The impact of the Sepsis-3 definition on ICU admission of patients with infection

Sepsis is defined as a life-threatening organ dysfunction due to a dysregulated inflammation following an infection. However, the impact of this definition on patient care is not fully clear. This study invest...

Authors: Jenny Klimpel, Lorenz Weidhase, Michael Bernhard, André Gries and Sirak Petros

Dispatcher-assisted cardiopulmonary resuscitation for traumatic patients with out-of-hospital cardiac arrest

Resuscitation efforts for traumatic patients with out-of-hospital cardiac arrest (OHCA) are not always futile. Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) during emergency calls could increase t...

Authors: Chien-Hsin Lu, Pin-Hui Fang and Chih-Hao Lin

The boundaries of our imagination are not restricted by limits, but by lack of knowledge

Authors: Kristi G. Bache and Marius Rehn

Prehospital administration of surfactant to a premature neonate in respiratory distress

The population of the Kingdom of Bhutan is scattered in small villages throughout the eastern Himalaya. Infants born prematurely in villages have no access to neonatal intensive care until they are transported...

Authors: Charles Haviland Mize, Lhab Dorji and Ken Zafren

Variation in accessibility of the population to an Emergency Medical Communication Centre: a multicentre observational study

Access to an Emergency Medical Communication Centre is essential for the population in emergency situations. Handling inbound calls without delay requires managing activity, process and outcome measures of the...

Authors: Yann Penverne, Brice Leclere, Eric Lecarpentier, Jean-Sébastien Marx, Benjamin Gicquel, Laurent Goix and Paul-Georges Reuter

Ventilation feedback device for manual ventilation in simulated respiratory arrest: a crossover manikin study

Studies have shown that providing adequate ventilation during CPR is essential. While hypoventilation is often feared by most caregivers on the scene, the most critical problem remains hyperventilation. We dev...

Authors: Abdo Khoury, Alban De Luca, Fatimata S. Sall, Lionel Pazart and Gilles Capellier

Predicting acute coronary syndrome in males and females with chest pain who call an emergency medical communication centre

Chest pain is a frequent reason for calls in emergency medical communication centre (EMCC). Detecting a coronary origin by phone is a challenge. This is especially so as the presentations differ according to g...

Authors: Paul-Georges Reuter, Catherine Pradeau, Samantha Huo Yung Kai, Thibault Lhermusier, Arnaud Bourdé, Eric Tentillier, Xavier Combes, Vanina Bongard, Jean-Louis Ducassé and Sandrine Charpentier

A Delphi consensus study for teaching “Basic Trauma Management” to third-year medical students

The Basic-Trauma Management (BTM) course has been taught to third-year medical students in small groups for many years without substantial changes. With the introduction of a new curriculum for Swiss medical s...

Authors: Joana Berger-Estilita, Sabine Nabecker and Robert Greif

Determining optimal needle size for decompression of tension pneumothorax in children – a CT-based study

For neonates and children requiring decompression of tension pneumothorax, specific recommendations for the choice of needle type and size are missing. The aim of this retrospective study was to determine opti...

Authors: Georg Leonhard, Daniel Overhoff, Lucas Wessel, Tim Viergutz, Marcus Rudolph, Michael Schöler, Holger Haubenreisser and Tom Terboven

Limitation of treatment in prehospital care – the experiences of helicopter emergency medical service physicians in a nationwide multicentre survey

Making ethically sound treatment limitations in prehospital care is a complex topic. Helicopter Emergency Medical Service (HEMS) physicians were surveyed on their experiences with limitations of care orders in...

Authors: Heidi Kangasniemi, Piritta Setälä, Heini Huhtala, Antti Kämäräinen, Ilkka Virkkunen, Joonas Tirkkonen, Arvi Yli-Hankala and Sanna Hoppu

Palliative care in the emergency department as seen by providers and users: a qualitative study

Much effort has been made to explore how patients with advanced chronic illness and their families experience care when they attend the Emergency Department, and many studies have investigated how healthcare p...

Authors: Silvia Di Leo, Sara Alquati, Cristina Autelitano, Massimo Costantini, Gianfranco Martucci, Francesco De Vincenzo, Beata Kuczynska, Alessandra Morini, Laura Trabucco, Raffaella Ursicelli, Gianluca Catania and Luca Ghirotto

The management of unanticipated difficult airways in children of all age groups in anaesthetic practice - the position paper of an expert panel

Children form a specific group of patients, as there are significant differences between children and adults in both anatomy and physiology. Difficult airway may be unanticipated or anticipated. Difficulties e...

Authors: Wojciech Walas, Dawid Aleksandrowicz, Maria Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska and Zenon P. Halaba

Presence of a pre-hospital enhanced care team reduces on scene time and improves triage compliance for stab trauma

A reduction in pre-hospital scene time for patients with penetrating trauma is associated with reduced mortality, when combined with appropriate hospital triage. This study investigated the relationship betwee...

Authors: Alan Cowley, Mark Durham, Duncan Aldred, Richard Crabb, Paul Crouch, Adam Heywood, Andy McBride, Julia Williams and Richard Lyon

Impact of traumatic events incurred by asylum-seekers on mental health and utilization of medical services

Asylum-seekers from Africa immigrate to Israel through the Sinai desert and are often exposed to traumatic events.

Authors: Maya Siman-Tov, Moran Bodas, Alex Wang, Michael Alkan and Bruria Adini

Chest pain in the ambulance; prevalence, causes and outcome - a retrospective cohort study

Chest pain is common in acute ambulance transports. This study aims to characterize and compare ambulance-transported chest pain patients to non-chest pain patients and evaluate if patient characteristics and ...

Authors: Claus Kjær Pedersen, Carsten Stengaard, Kristian Friesgaard, Karen Kaae Dodt, Hanne Maare Søndergaard, Christian Juhl Terkelsen and Morten Thingemann Bøtker

Implementation of new guidelines in the prehospital services: a nationwide survey of Norway

A debate regarding the potential harmful effects of rigid neck collar and backboard usage among prehospital and hospital care providers in Norway provoked the development of an evidence-based guideline. “The N...

Authors: Nina Øye Thorvaldsen, Lars Didrik Flingtorp, Torben Wisborg and Elisabeth Jeppesen

Extracorporeal membrane oxygenation mitigates myocardial injury and improves survival in porcine model of ventricular fibrillation cardiac arrest

Despite decades of improved strategy in conventional cardiopulmonary resuscitation (CCPR), survival rates of favorable neurological outcome after cardiac arrest (CA) remains poor. It is indicated that the surv...

Authors: Bo Liu, Qiang Zhang, Yong Liang, Yun Zhang, Xiaoli Yuan, Jiyang Ling and Chunsheng Li

Neurocritical care physicians’ doubt about whether to withdraw life-sustaining treatment the first days after devastating brain injury: an interview study

Multilevel uncertainty exists in the treatment of devastating brain injury and variation in end-of-life decision-making is a concern. Cognitive and emotional doubt linked to making challenging decisions have n...

Authors: Annette Robertsen, Eirik Helseth, Jon Henrik Laake and Reidun Førde

Postponing intubation in spontaneously breathing major trauma patients upon emergency room admission does not impair outcome

Pre-hospital emergency anaesthesia and tracheal intubation are life-saving interventions in trauma patients. However, there is evidence suggesting that the risks associated with both procedures outweigh the be...

Authors: Philipp Schwaiger, Herbert Schöchl, Daniel Oberladstätter, Helmut Trimmel and Wolfgang G. Voelckel

Prehospital cardiopulmonary resuscitation duration and neurological outcome after out-of-hospital cardiac arrest among children by location of arrest: a Nationwide cohort study

Little is known about the associations between the duration of prehospital cardiopulmonary resuscitation (CPR) by emergency medical services (EMS) and outcomes among paediatric patients with out-of-hospital ca...

Authors: Haruka Shida, Tasuku Matsuyama, Kosuke Kiyohara, Tetsuhisa Kitamura, Takefumi Kishimori, Takeyuki Kiguchi, Chika Nishiyama, Daisuke Kobayashi, Satoe Okabayashi, Tomonari Shimamoto, Takashi Kawamura and Taku Iwami

Prehospital management provided by medical on-scene commanders in tunnel incidents in Oslo, Norway – an interview study

High demands are placed on the emergency medical services to handle rescue operations in challenging environments such as tunnels. In Oslo, Norway a specialised management function within the emergency medical...

Authors: Johan Hylander, Britt-Inger Saveman, Ulf Björnstig and Lina Gyllencreutz

New clinical guidelines on the spinal stabilisation of adult trauma patients – consensus and evidence based

Traumatic spinal cord injury is a relatively rare injury in Denmark but may result in serious neurological consequences. For decades, prehospital spinal stabilisation with a rigid cervical collar and a hard ba...

Authors: Christian Maschmann, Elisabeth Jeppesen, Monika Afzali Rubin and Charlotte Barfod

Clinical reasoning in the emergency medical services: an integrative review

Clinical reasoning is the process of gathering and understanding information conducted by clinicians in the emergency medical services (EMS) so as to make informed decisions. Research on clinical reasoning spa...

Authors: Ulf Andersson, Hanna Maurin Söderholm, Birgitta Wireklint Sundström, Magnus Andersson Hagiwara and Henrik Andersson

Single mission workload and influencing factors in German prehospital emergency medicine - a nationwide prospective survey of 1361emergency missions

Workload is a major determinant of system performance and human well-being. This study aims to evaluate workload in prehospital emergency medicine on a single mission level and investigates influencing factors...

Authors: Johannes Prottengeier, Johann Georg Keunecke, Christine Gall, Christian Eiche, Andreas Moritz and Torsten Birkholz

Epinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study

The beneficial effect of epinephrine during resuscitation from out-of-hospital cardiac arrest (OHCA) has been inconclusive, and potential harm has been suggested, particularly in trauma victims. Although no si...

Authors: Ryo Yamamoto, Masaru Suzuki, Kei Hayashida, Jo Yoshizawa, Atsushi Sakurai, Nobuya Kitamura, Takashi Tagami, Taka-aki Nakada, Munekazu Takeda and Junichi Sasaki

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

Authors: Liu-Jia-Zi Shao, Shao-Hua Liu and Fu-Shan Xue