Articles

The rate of short-term revisits after diagnosis of non-specific abdominal pain is similar for surgeons and emergency physicians - results from a single tertiary hospital emergency department

Acute abdominal pain can be a diagnostic challenge even for experienced surgeons. Delayed diagnosis can lead to higher morbidity, mortality and increased costs. While readmission rate has been used to evaluate...

Authors: Leena Saaristo, Mika T. Ukkonen, Johanna M. Laukkarinen and Satu-Liisa K. Pauniaho

Resuscitative endovascular balloon occlusion of the aorta may contribute to improved survival

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an increasingly used trauma resuscitation procedure, however, there are no reports of whether or not the survival of patients treated with R...

Authors: Makoto Aoki, Toshikazu Abe, Shuichi Hagiwara, Daizoh Saitoh and Kiyohiro Oshima

Efficacy and efficiency of indoor nighttime human external cargo mission simulation in a high-fidelity training Centre

The human external cargo (HEC) operations conducted by Helicopter Emergency Medical Services (HEMS) rarely take place at night, making it difficult for crew members to attain and maintain the level of expertis...

Authors: Urs Pietsch, Volker Lischke, Stephen J. M. Sollid, Stephan Prückner, Lorenz Theiler, Robert Greif and Roland Albrecht

Identifying the relative importance of predictors of survival in out of hospital cardiac arrest: a machine learning study

Studies examining the factors linked to survival after out of hospital cardiac arrest (OHCA) have either aimed to describe the characteristics and outcomes of OHCA in different parts of the world, or focused o...

Authors: Nooraldeen Al-Dury, Annica Ravn-Fischer, Jacob Hollenberg, Johan Israelsson, Per Nordberg, Anneli Strömsöe, Christer Axelsson, Johan Herlitz and Araz Rawshani

The predictive value of variables measurable in the ambulance and the development of the Predict Sepsis screening tools: a prospective cohort study

Despite sepsis being a time critical condition with a high mortality, it is often not identified in a timely fashion. The aim of the current study was to create a screening tool based on bedside measurable var...

Authors: Ulrika Margareta Wallgren, Jan Sjölin, Hans Järnbert-Pettersson and Lisa Kurland

Can we predict patient outcome before extracorporeal membrane oxygenation for refractory cardiac arrest?

Refractory cardiac arrest resistant to conventional cardiopulmonary resuscitation (C-CPR) has a poor outcome. Although previous reports showed that extracorporeal cardiopulmonary resuscitation (E-CPR) can impr...

Authors: Fu-Yuan Siao, Chun-Wen Chiu, Chun-Chieh Chiu, Yu-Jun Chang, Ying-Chen Chen, Yao-Li Chen, Yung-Kun Hsieh, Chu-Chung Chou and Hsu-Hen Yen

The effect of COVID-19 on trauma system in one city of China

Authors: Fenglu Yang and Xiao Lu

Comparing complications of small-bore chest tubes to large-bore chest tubes in the setting of delayed hemothorax: a retrospective multicenter cohort study

Previous studies have provided initial data suggesting that small-bore (SB, ≤ 14Fr) chest tubes have the same efficacy as large-bore (LB, > 14 Fr) chest tubes for acute hemothorax (HTX), but data continue to b...

Authors: A. Orlando, J. Cordero, M. M Carrick, A. H. Tanner II, K. Banton, R. Vogel, M. Lieser, D. Acuna and D. Bar-Or

Strategies to measure and improve emergency department performance: a scoping review

Over the last two decades, Emergency Department (ED) crowding has become an increasingly common occurrence worldwide. Crowding is a complex and challenging issue that affects EDs’ capacity to provide safe, tim...

Authors: Elizabeth E. Austin, Brette Blakely, Catalin Tufanaru, Amanda Selwood, Jeffrey Braithwaite and Robyn Clay-Williams

Clinical experience of whole-body computed tomography as the initial evaluation tool after extracorporeal cardiopulmonary resuscitation in patients of out-of-hospital cardiac arrest

The routine application of whole-body CT after extracorporeal cardiopulmonary resuscitation (ECPR) in out-of-hospital cardiac arrest (OHCA) has not been extensively investigated. We aimed to evaluate the benef...

Authors: Kelvin Jeason Yang, Chih-Hsien Wang, Yu-Cheng Huang, Li-Jung Tseng, Yih-Sharng Chen and Hsi-Yu Yu

Self-rated worry is associated with hospital admission in out-of-hours telephone triage – a prospective cohort study

Telephone triage manages patient flow in acute care, but a lack of visual cues and vague descriptions of symptoms challenges clinical decision making. We aim to investigate the association between the caller’s...

Authors: Hejdi Gamst-Jensen, Erika Frischknecht Christensen, Freddy Lippert, Fredrik Folke, Ingrid Egerod, Linda Huibers, Mikkel Brabrand, Janne Schurmann Tolstrup and Lau Caspar Thygesen

Management of decision of withholding and withdrawing life-sustaining treatments in French EDs

Decisions of withholding or withdrawing life sustaining-treatments in emergency department are part of current practice but the decision-making process remains poorly described in the literature.

Authors: Marion Douplat, Laurie Fraticelli, Clement Claustre, Alexandra Peiretti, Patrice Serre, Magali Bischoff, Laurent Jacquin, Julie Freyssenge, Anne-Marie Schott, Karim Tazarourte, Soizic Frugier and Carlos E. L. Khoury

Barriers and challenges in the process of including critically ill patients in clinical studies

Clinical research in severely ill or injured patients is required to improve healthcare but may be challenging to perform in practice. The aim of this study was to analyse barriers and challenges in the proces...

Authors: Jørgen Dahlberg, Camilla Eriksen, Annette Robertsen and Sigrid Beitland

Assessment of rewarming methods in unplanned out-of-hospital births from a prospective cohort

Mobile intensive care units frequently manage unplanned out-of-hospital births (UOHB). Rewarming methods during pre-hospital management of UOHB have not yet been compared. The aim was to compare rewarming meth...

Authors: François Javaudin, Mélodie Roche, Lucile Trutt, Isabelle Bunker, Valérie Hamel, Sybille Goddet, François Templier, Christine Potiron, Quentin Le Bastard, Philippe Pes, Gilles Bagou, Jean-Louis Chabernaud, Emmanuel Montassier and Brice Leclère

Championing survival: connecting the unknown network of responders to address out-of-hospital cardiac arrest

Early intervention for out-of-hospital cardiac arrest (OHCA) presents a challenge for Emergency Medical Services (EMS) across Europe. Strategies designed to address this include education and training initiati...

Authors: Ronan McBride, Chantal F. Ski, David R. Thompson, Tom Quinn and Mark H. Wilson

The selection of an optimal transportation strategy in urgent stroke missions: a simulation study

Stroke causes death, disability and increases the use of healthcare resources worldwide. The outcome of intravenous thrombolysis and mechanical endovascular thrombectomy highly depends on the delay from sympto...

Authors: Jukka Pappinen, Tuuli Miettinen, Päivi Laukkanen-Nevala, Pekka Jäkälä, Anne-Mari Kantanen, Pekka Mäntyselkä and Jouni Kurola

Point-of-care ultrasound induced changes in management of unselected patients in the emergency department - a prospective single-blinded observational trial

Point-of-Care ultrasound (POCUS) changes the management in specific groups of patients in the Emergency Department (ED). It seems intuitive that POCUS holds an unexploited potential on a wide variety of patien...

Authors: Jesper Weile, Christian A. Frederiksen, Christian B. Laursen, Ole Graumann, Erik Sloth and Hans Kirkegaard

The first seven years of nationally organized helicopter emergency medical services in Finland – the data from quality registry

Helicopter Emergency Medical Services (HEMS) play an important role in prehospital care of the critically ill. Differences in funding, crew composition, dispatch criteria and mission profile make comparison be...

Authors: Anssi Saviluoto, Johannes Björkman, Anna Olkinuora, Ilkka Virkkunen, Hetti Kirves, Piritta Setälä, Ilkka Pulkkinen, Päivi Laukkanen-Nevala, Lasse Raatiniemi, Helena Jäntti, Timo Iirola and Jouni Nurmi

Changing role of EMS –analyses of non-conveyed and conveyed patients in Finland

Emergency Medical Services (EMS) and Emergency Departments (ED) have seen increasing attendance rates in the last decades. Currently, EMS are increasingly assessing and treating patients without the need to co...

Authors: Jani Paulin, Jouni Kurola, Sanna Salanterä, Hans Moen, Nischal Guragain, Mari Koivisto, Niina Käyhkö, Venla Aaltonen and Timo Iirola

Prediction of in-hospital mortality in patients with post traumatic brain injury using National Trauma Registry and Machine Learning Approach

The use of machine learning techniques to predict diseases outcomes has grown significantly in the last decade. Several studies prove that the machine learning predictive techniques outperform the classical mu...

Authors: Ahmad Abujaber, Adam Fadlalla, Diala Gammoh, Husham Abdelrahman, Monira Mollazehi and Ayman El-Menyar

Decision support tool and suggestions for the development of guidelines for the helicopter transport of patients with COVID-19

The novel coronavirus SARS-CoV2 emerged in December 2019 and is now pandemic. Initial analysis suggests that 5% of infected patients will require critical care, and that respiratory failure requiring intubatio...

Authors: Per P. Bredmose, Monica Diczbalis, Emma Butterfield, Karel Habig, Andrew Pearce, Svein Are Osbakk, Ville Voipio, Marcus Rudolph, Alistair Maddock and John O’Neill

Possible advantages of early stabilization of spinal fractures in multiply injured patients with leading thoracic trauma - analysis based on the TraumaRegister DGU®

Major trauma often comprises fractures of the thoracolumbar spine and these are often accompanied by relevant thoracic trauma. Major complications can be ascribed to substantial simultaneous trauma to the ches...

Authors: Sven Hager, Helge Eberbach, Rolf Lefering, Thorsten O. Hammer, David Kubosch, Christoph Jäger, Norbert P. Südkamp and Jörg Bayer

Clinical outcomes of extracorporeal membrane oxygenation in acute traumatic lung injury: a retrospective study

Therapeutic extracorporeal membrane oxygenation (ECMO) is a challenging procedure in patients who have experienced severe trauma. Particularly, patients with traumatic lung injury and posttraumatic acute respi...

Authors: Hong Kyu Lee, Hyoung Soo Kim, Sang Ook Ha, Sunghoon Park, Hee Sung Lee, Soo Kyung Lee and Sun Hee Lee

Transport of COVID-19 and other highly contagious patients by helicopter and fixed-wing air ambulance: a narrative review and experience of the Swiss air rescue Rega

The current COVID-19 pandemic highlights the challenges air ambulance services are facing when transporting highly infectious patients for several hours in enclosed spaces. This overview provides an example of...

Authors: Roland Albrecht, Jürgen Knapp, Lorenz Theiler, Marcus Eder and Urs Pietsch

A potential method of identifying stroke and other intracranial lesions in a prehospital setting

Identifying stroke and other intracranial lesions in patients with a decreased level of consciousness may be challenging in prehospital settings. Our objective was to investigate whether the combination of sys...

Authors: Anssi Saviluoto, Heini Harve-Rytsälä, Mitja Lääperi, Hetti Kirves, Helena Jäntti and Jouni Nurmi

Radiologic discrepancies in diagnosis of fractures in a Dutch teaching emergency department: a retrospective analysis

Missed fractures in the emergency department (ED) are common and may lead to patient morbidity.

Authors: Laura Mattijssen-Horstink, Judith Joëlle Langeraar, Gert Jan Mauritz, William van der Stappen, Maarten Baggelaar and Edward Camillus Thwan Han Tan

Lausanne medical dispatch centre’s response to COVID-19

The COVID-19 crisis is an unprecedented event. It is therefore essential for dispatch centres to share their experiences while the crisis is underway, similar to hospitals, so that we will all benefit from fee...

Authors: Fabrice Dami and Vincent Berthoz

Nitrous oxide/oxygen plus acetaminophen versus morphine in ST elevation myocardial infarction: open-label, cluster-randomized, non-inferiority study

Studies have shown disparate results on the consequences of morphine use in ST-segment elevation myocardial infarction (STEMI). No study has evaluated alternative treatments that could be at least non-inferior...

Authors: Sandrine Charpentier, Michel Galinski, Vincent Bounes, Agnès Ricard-Hibon, Carlos El-Khoury, Meyer Elbaz, François-Xavier Ageron, Stéphane Manzo-Silberman, Louis Soulat, Frédéric Lapostolle, Alexandre Gérard, Delphine Bregeaud, Vanina Bongard and Eric Bonnefoy-Cudraz

Association of helicopter transportation and improved mortality for patients with major trauma in the northern French Alps trauma system: an observational study based on the TRENAU registry

Prompt prehospital triage and transportation are essential in an organised trauma system. The benefits of helicopter transportation on mortality in a physician-staffed pre-hospital trauma system remains unknow...

Authors: Francois-Xavier Ageron, Guillaume Debaty, Dominique Savary, Frederic Champly, Francois Albasini, Pascal Usseglio, Cécile Vallot, Samuel Galvagno and Pierre Bouzat

Undertriage in trauma: an ignored quality indicator?

Early identification of life-threatening injuries is essential to reduce morbidity and mortality in trauma patients. Failure to detect severe injury may cause delayed diagnosis and therapeutic interventions an...

Authors: Elisabeth Jeppesen, Mathias Cuevas-Østrem, Cathrine Gram-Knutsen and Oddvar Uleberg

Performance of pre-hospital evaluations in ruling out invasive chest stab wounds

Some guidelines advocate for managing patients with penetrating thoracic wounds in trauma centres with cardiothoracic surgery. This systematic approach is questionable. Only 15% of these patients require surge...

Authors: Pascal Augustin, Elise Guivarch, Quentin Pellenc, Yves Castier, Sandrine Boudinet, Sebastien Tanaka, Philippe Montravers and Alexy Tran-Dinh

Top five research priorities in physician-provided pre-hospital critical care – appropriate staffing, training and the effect on outcomes

Authors: Marius Rehn, Kristi G. Bache, Hans Morten Lossius and David Lockey

The ticking clock: does actively making an enhanced care team aware of the passage of time improve pre-hospital scene time following traumatic incidents?

Pre-hospital enhanced care teams like Helicopter Emergency Medical Services (HEMS) are often dispatched to major trauma patients, including patients with traumatic brain injuries and those with major haemorrha...

Authors: L. Curtis, E. ter Avest, J. Griggs, J. Wiliams and R. M. Lyon

Therapeutic management of severe hypothermia with veno-arterial ECMO: where do we stand? Case report and review of the current literature

Severe accidental hypothermia is associated with high morbidity and mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides an efficient rewarming method with complete cardiopulmonary s...

Authors: Aurélien Ledoux and Piehr Saint Leger

Longitudinal analysis of health status the first year after trauma in severely injured patients

While survival rates after a trauma are increasing a considerable part of the trauma population are still at risk for both short and long term disabilities. Little is known about prognostic factors over time a...

Authors: Roos Johanna Maria Havermans, Mariska Adriana Cornelia de Jongh, Leonie de Munter and Koen Willem Wouter Lansink

What clinical crew competencies and qualifications are required for helicopter emergency medical services? A review of the literature

Patients served by Helicopter Emergency Medical Services (HEMS) tend to be acutely injured or unwell and in need of stabilisation followed by rapid and safe transport. It is therefore hypothesised that a parti...

Authors: Siobhán Masterson, Conor Deasy, Mark Doyle, David Hennelly, Shane Knox and Jan Sorensen

A novel ECG-biomarker for cardiac arrest during hypothermia

Treatment of arrhythmias evoked by accidental or therapeutic hypothermia and rewarming remains challenging. We aim to find an ECG-biomarker that can predict ventricular arrhythmias at temperatures occurring in...

Authors: Erik Sveberg Dietrichs, Torkjel Tveita, Rachel Myles and Godfrey Smith

Including oxygen supplement in the early warning score: a prediction study comparing TOKS, modified TOKS and NEWS in a cohort of emergency patients

Early warning scores (EWS) are widely used in emergency departments and on general wards to detect critical illness and deterioration. TOKS (“Tidlig Opsporing af Kritisk Sygdom”) is an early warning score used...

Authors: Maj Juhl Skov, Jacob Dynesen, Marie K. Jessen, Janet Yde Liesanth, Julie Mackenhauer and Hans Kirkegaard

Template for documenting and reporting data in physician-staffed pre-hospital services: a consensus-based update

Physician-staffed emergency medical services (p-EMS) are resource demanding, and research is needed to evaluate any potential effects of p-EMS. Templates, designed through expert agreement, are valuable and fe...

Authors: Kristin Tønsager, Andreas Jørstad Krüger, Kjetil Gorseth Ringdal and Marius Rehn

Patient experience of severe acute dyspnoea and relief during treatment in ambulances: a prospective observational study

Acute dyspnoea is common among ambulance patients, but little is known of the patients’ experience of symptom. We aimed to investigate ambulance patients initial perceived intensity of acute dyspnoea, and whet...

Authors: Tim Alex Lindskou, Ulla Møller Weinreich, Kenneth Lübcke, Torben Anders Kløjgaard, Birgitte Schantz Laursen, Søren Mikkelsen and Erika Frischknecht Christensen

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

Following the publication of the original article [1], the authors unfortunately became aware of some typesetting and resolution problems in Figs. 1 and 2.

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

Septic shock: ECMO beyond ARDS? Introducing the Simon two-stage protocol when randomisation is considered unethical

Authors: Alexander Buia, Hans-Bernd Hopf, Eva Herrmann, Thomas Schmandra and Ernst Hanisch

Impact of blunt chest trauma on outcome after traumatic brain injury– a matched-pair analysis of the TraumaRegister DGU®

Traumatic brain injury (TBI) is associated with high rates of long-term disability and mortality. Our aim was to investigate the effects of thoracic trauma on the in-hospital course and outcome of patients wit...

Authors: Mark Schieren, Frank Wappler, Arasch Wafaisade, Rolf Lefering, Samir G. Sakka, Jost Kaufmann, Hi-Jae Heiroth, Jerome Defosse and Andreas B. Böhmer

Trauma research in the Nordic countries, 1995–2018 – a systematic review

Trauma is a major cause of mortality and reduced quality of life. Most trauma-related research originates from trauma centres, and there are limited available data regarding the treatment of trauma patients th...

Authors: Elisabeth Jeppesen, Valdemar Vea Iversen, Ingrid Schrøder Hansen, Eirik Reierth and Torben Wisborg

Influence of physical strain at high altitude on the quality of cardiopulmonary resuscitation

High quality cardiopulmonary resuscitation is a key factor in survival with good overall quality of life after out-of-hospital cardiac arrest. Current evidence is predominantly based on studies conducted at lo...

Authors: Alexander Egger, Maximilian Niederer, Katharina Tscherny, Josef Burger, Verena Fuhrmann, Calvin Kienbacher, Dominik Roth, Wolfgang Schreiber and Harald Herkner

The volume-outcome relationship among severely injured patients admitted to English major trauma centres: a registry study

Many countries have centralized and dedicated trauma centres with high volumes of trauma patients. However, the volume-outcome relationship in severely injured patients (Injury Severity Score (ISS) > 15) remai...

Authors: Charlie A. Sewalt, Eveline J. A. Wiegers, Fiona E. Lecky, Dennis den Hartog, Stephanie C. E. Schuit, Esmee Venema and Hester F. Lingsma

London Trauma Conference 2019

Authors:

Artificial intelligence algorithm to predict the need for critical care in prehospital emergency medical services

In emergency medical services (EMSs), accurately predicting the severity of a patient’s medical condition is important for the early identification of those who are vulnerable and at high-risk. In this study, ...

Authors: Da-Young Kang, Kyung-Jae Cho, Oyeon Kwon, Joon-myoung Kwon, Ki-Hyun Jeon, Hyunho Park, Yeha Lee, Jinsik Park and Byung-Hee Oh

Rescue under ongoing CPR from an upper floor: evaluation of three different evacuation routes and mechanical and manual chest compressions: a manikin trial

If transport under ongoing cardiopulmonary resuscitation (CPR) from an upper floor is indicated, the ideal CPR-method and evacuation route is unknown hitherto. We aimed to elaborate a strategy for evacuation o...

Authors: Hendrik Drinhaus, Sebastian Nüsgen, Niels Adams, Wolfgang A. Wetsch and Thorsten Annecke

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

To determine the prevalence and characteristics of prechiasmatic visual system injuries (VSI) among seriously injured patients with concomitant head trauma in Europe by means of a multinational...

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