Articles

Intensive care–treated cardiac arrest: a retrospective study on the impact of extended age on mortality, neurological outcome, received treatments and healthcare-associated costs

Cardiac arrest (CA) is a leading cause of death worldwide. As population ages, the need for research focusing on CA in elderly increases. This study investigated treatment intensity, 12-month neurological outc...

Authors: Ester Holmström, Ilmar Efendijev, Rahul Raj, Pirkka T. Pekkarinen, Erik Litonius and Markus B. Skrifvars

Reliability of mechanical ventilation during continuous chest compressions: a crossover study of transport ventilators in a human cadaver model of CPR

Previous studies have stated that hyperventilation often occurs in cardiopulmonary resuscitation (CPR) mainly due to excessive ventilation frequencies, especially when a manual valve bag is used. Transport ven...

Authors: Simon Orlob, Johannes Wittig, Christoph Hobisch, Daniel Auinger, Gabriel Honnef, Tobias Fellinger, Robin Ristl, Otmar Schindler, Philipp Metnitz, Georg Feigl and Gerhard Prause

Alcohol and trauma: the influence of blood alcohol levels on the severity of injuries and outcome of trauma patients - a retrospective analysis of 6268 patients of the TraumaRegister DGU^®

Blood alcohol level (BAL) has previously been considered as a factor influencing the outcome of injured patients. Despite the well-known positive correlation between alcohol-influenced traffic participation an...

Authors: Thomas Brockamp, Andreas Böhmer, Rolf Lefering, Bertil Bouillon, Arasch Wafaisade, Manuel Mutschler, Paola Kappel and Matthias Fröhlich

Challenges in the PREHOSPITAL emergency management of geriatric trauma patients – a scoping review

Despite a widely acknowledged increase in older people presenting with traumatic injury in western populations there remains a lack of research into the optimal prehospital management of this vulnerable patien...

Authors: Michael Eichinger, Henry Douglas Pow Robb, Cosmo Scurr, Harriet Tucker, Stefan Heschl and George Peck

Mobilisation of emergency services for chemical incidents in Sweden - a multi-agency focus group study

In chemical incidents, infrequent but potentially disastrous, the World Health Organization calls for inter-organizational coordination of actors involved. Multi-organizational studies of chemical response cap...

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

Large variations of oxygen delivery in self-inflating resuscitation bags used for preoxygenation - a mechanical simulation

Self-Inflating Resuscitation Bags (SIRB) are common and essential tools in airway management and ventilation. They are often used in resuscitation and emergency anaesthesia outside the operating theatre. There...

Authors: Sven Grauman, Joakim Johansson and Thomas Drevhammar

Emergency medical dispatchers’ ability to identify large vessel occlusion stroke during emergency calls

In acute ischemic stroke, conjugated eye deviation (CED) is an evident sign of cortical ischemia and large vessel occlusion (LVO). We aimed to determine if an emergency dispatcher can recognise LVO stroke duri...

Authors: Pauli E. T. Vuorinen, Jyrki P. J. Ollikainen, Pasi A. Ketola, Riikka-Liisa K. Vuorinen, Piritta A. Setälä and Sanna E. Hoppu

Survivors of avalanche accidents: posttraumatic stress disorder symptoms and quality of life: a multicentre study

As any traumatic event, avalanches could trigger psychological disorders on survivors. Our objectives were to determine the prevalence of post-traumatic stress disorder among avalanche survivors and to evaluat...

Authors: Charlotte Léonard, Anaëlle Charriau-Perret, Guillaume Debaty, Loïc Belle, Cécile Ricard, Caroline Sanchez, Pierre-Marie Dupré, Gregory Panoff, Thierry Bougerol, Damien Viglino and Marc Blancher

Prehospital characteristics of COVID-19 patients in Helsinki – experience of the first wave of the pandemic

There is a lack of knowledge how patients with COVID-19 disease differ from patients with similar signs or symptoms (but who will have a diagnosis other than COVID-19) in the prehospital setting. The aim of th...

Authors: Markku Kuisma, Heini Harve-Rytsälä, Jussi Pirneskoski, James Boyd, Mitja Lääperi, Ari Salo and Tuukka Puolakka

Selection of CT variables and prognostic models for outcome prediction in patients with traumatic brain injury

Traumatic brain injuries (TBI) are associated with high risk of morbidity and mortality. Early outcome prediction in patients with TBI require reliable data input and stable prognostic models. The aim of this ...

Authors: Djino Khaki, Virpi Hietanen, Alba Corell, Helena Odenstedt Hergès and Johan Ljungqvist

Management of severe liver injuries: push, pack, pringle – and plug!

Authors: Arezo Kanani, Knut Olav Sandve and Kjetil Søreide

Transcatheter arterial embolization for severe blunt liver injury in hemodynamically unstable patients: a 15-year retrospective study

Transcatheter arterial embolization (TAE) is the first-line nonsurgical treatment for severe blunt liver injury in patients, whereas operative management (OM) is recommended for hemodynamically unstable patien...

Authors: Satoshi Tamura, Takaaki Maruhashi, Fumie Kashimi, Yutaro Kurihara, Tomonari Masuda, Tasuku Hanajima, Yuichi Kataoka and Yasushi Asari

Incidence and challenges of helicopter emergency medical service (HEMS) rescue missions with helicopter hoist operations: analysis of 11,228 daytime and nighttime missions in Switzerland

We aimed to investigate the medical characteristics of helicopter hoist operations (HHO) in HEMS missions.

Authors: Urs Pietsch, Jürgen Knapp, Michael Mann, Lorenz Meuli, Volker Lischke, Mario Tissi, Stephen Sollid, Simon Rauch, Volker Wenzel, Stefan Becker and Roland Albrecht

Bradycardia in a newborn with accidental severe hypothermia: treat or don’t touch? A case report

Hypothermia significantly affects mortality and morbidity of newborns. Literature about severe accidental hypothermia in neonates is limited. We report a case of a neonate suffering from severe accidental hypo...

Authors: Astrid Kuonen, Thomas Riva and Gabor Erdoes

Effect of arterial oxygen partial pressure inflection point on Venoarterial extracorporeal membrane oxygenation for emergency cardiac support

Temporary circulatory support is a bridge between acute circulatory failure and definitive treatment or recovery. Currently, venoarterial extracorporeal membrane oxygenation (VA-ECMO) is considered to be one o...

Authors: Hao Zhou, Yi Zhu, Zhongman Zhang, Jinru Lv, Wei Li, Deliang Hu, Xufeng Chen and Yong Mei

An updated national survey of triage and triage related work in Sweden: a cross-sectional descriptive and comparative study

Triage and triage related work has been performed in Swedish Emergency Departments (EDs) since the mid-1990s. According to two national surveys from 2005 to 2011, triage was carried out with different triage s...

Authors: Sara C. Wireklint, Carina Elmqvist and Katarina E. Göransson

Description of call handling in emergency medical dispatch centres in Scandinavia: recognition of out-of-hospital cardiac arrests and dispatcher-assisted CPR

The European resuscitation council have highlighted emergency medical dispatch centres as an important key player for early recognition of Out-of-Hospital Cardiac Arrest (OHCA) and in providing dispatcher assi...

Authors: Camilla Hardeland, Andreas Claesson, Marieke T. Blom, Stig Nikolaj Fasmer Blomberg, Fredrik Folke, Jacob Hollenberg, Jo Kramer-Johansen, Freddy Lippert, Anette Nord, Anne Mette Nygaard, Theresa Mariero Olasveengen, Mattias Ringh, Leif Svensson and Thea Palsgaard Møller

Ambulance deceleration causes increased intra cranial pressure in supine position: a prospective observational proof of principle study

Ambulance drivers in the Netherlands are trained to drive as fluent as possible when transporting a head injured patient to the hospital. Acceleration and deceleration have the potential to create pressure cha...

Authors: Iscander M. Maissan, Boris Vlottes, Sanne Hoeks, Jan Bosch, Robert Jan Stolker and Dennis den Hartog

Preoperative vena cava filter placement in recurrent cerebral fat embolism following traumatic multiple fractures

Authors: Silvia Di Bari, Marcello Bisulli, Emanuele Russo, Luca Bissoni, Costanza Martino, Luigi Branca Vergano, Domenico Pietro Santonastaso, Vito Marco Ranieri and Vanni Agnoletti

Management of respiratory distress following prehospital implementation of noninvasive ventilation in a physician-staffed emergency medical service: a single-center retrospective study

Noninvasive ventilation (NIV) is recognized as first line ventilatory support for the management of acute pulmonary edema (APE) and chronic obstructive pulmonary disease (COPD) exacerbations. We aimed to study...

Authors: Adeline Dunand, Nicolas Beysard, Ludovic Maudet, Pierre-Nicolas Carron, Fabrice Dami, Lise Piquilloud, David Caillet-Bois and Mathieu Pasquier

Comparison of different mechanical chest compression devices in the alpine rescue setting: a randomized triple crossover experiment

Cardiopulmonary resuscitation in mountain environment is challenging. Continuous chest compressions during transport or hoist rescue are almost impossible without mechanical chest compression devices. Current ...

Authors: Egger Alexander, Tscherny Katharina, Fuhrmann Verena, Grafeneder Jürgen, Niederer Maximilian, Kienbacher Calvin, Schachner Andreas, Schreiber Wolfgang, Herkner Harald and Roth Dominik

Education in the placement of ultrasound-guided peripheral venous catheters: a systematic review

Placing a peripheral vein catheter can be challenging due to several factors, but using ultrasound as guidance increases the success rate. The purpose of this review is to investigate the knowledge already exi...

Authors: Rasmus Jørgensen, Christian B. Laursen, Lars Konge and Pia Iben Pietersen

Protocol for a cohort study of the impact of the COVID-19 pandemic on the rate and incidence of bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest

Survival after out-of-hospital cardiac arrest (OHCA) is dependent on early recognition, early cardiopulmonary resuscitation (CPR) and early defibrillation. The purpose of CPR is to maintain some blood flow unt...

Authors: Ingvild B. M. Tjelmeland, Jan Wnent, Siobhan Masterson, Jo Kramer-Johansen and Jan-Thorsten Gräsner

The ROX index as a predictor of standard oxygen therapy outcomes in thoracic trauma

Thoracic trauma is commonplace and accounts for 50–70% of the injuries found in severe trauma. Little information is available in the literature as to timing of endotracheal intubation. The main objective of t...

Authors: Adrien Cornillon, Juliette Balbo, Julien Coffinet, Thierry Floch, Mathieu Bard, Guillaume Giordano-Orsini, Jean-Marc Malinovsky, Lukshe Kanagaratnam, Daphne Michelet and Vincent Legros

Penetrating injuries in Germany – epidemiology, management and outcome an analysis based on the TraumaRegister DGU®

The management of penetrating wounds is a rare challenge for trauma surgeons in Germany and Central Europe as a result of the low incidence of this type of trauma. In Germany, penetrating injuries are reported...

Authors: D Bieler, E Kollig, L Hackenberg, JH Rathjen, R Lefering and A Franke

Standardized post-resuscitation damage assessment of two mechanical chest compression devices: a prospective randomized large animal trial

Mechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances. Current devices lack prospective and comparative data on their specific card...

Authors: Robert Ruemmler, Jakob Stein, Bastian Duenges, Miriam Renz and Erik Kristoffer Hartmann

Collective Critical Care Ambulance: an innovative transportation of critical care patients by bus in COVID-19 pandemic response

During the COVID-19 pandemic, as the number of available Intensive Care beds in France did not meet the needs, it appeared necessary to transfer a large number of patients from the most affected areas to the l...

Authors: Thierry Lentz, Charles Groizard, Abel Colomes, Anna Ozguler, Michel Baer and Thomas Loeb

Prioritizing health care workers and first responders for access to the COVID19 vaccine is not unethical, but both fair and effective – an ethical analysis

The Nordic countries have differed in their approach as to how much priority for COVID19 vaccine access should be given to health care workers. Two countries decided not to give health care workers highest pri...

Authors: Bjorg Thorsteinsdottir and Bo Enemark Madsen

Smartphone apps to support laypersons in bystander CPR are of ambivalent benefit: a controlled trial using medical simulation

Bystander-initiated resuscitation is essential for surviving out-of-hospital cardiac arrest. Smartphone apps can provide real-time guidance for medical laypersons in these situations. Are these apps a benefici...

Authors: Camilla Metelmann, Bibiana Metelmann, Louisa Schuffert, Klaus Hahnenkamp, Marcus Vollmer and Peter Brinkrolf

Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild traumatic brain injury: a prospective observational multicenter cohort study – “the PreTBI I study”

The biomarker serum S100 calcium-binding protein B (S100B) is used in in-hospital triage of adults with mild traumatic brain injury to rule out intracranial lesions. The biomarker glial fibrillary acidic prote...

Authors: Sophie-Charlott Seidenfaden, Julie Linding Kjerulff, Niels Juul, Hans Kirkegaard, Mette Fogh Møller, Anna-Marie Bloch Münster and Morten Thingemann Bøtker

Costoclavicular-serratus anterior muscle space brachial plexus block provides complete and fast analgesia for patients with upper limb trauma

Authors: Qi Chen, Ke Wei and Bin Yang

Do team and task performance improve after training situation awareness? A randomized controlled study of interprofessional intensive care teams

When working in complex environments with critically ill patients, team performance is influenced by situation awareness in teams. Moreover, improved situation awareness in the teams will probably improve team...

Authors: Karin Jonsson, Christine Brulin, Maria Härgestam, Marie Lindkvist and Magnus Hultin

European paramedic curriculum—a call for unity in paramedic education on a European level

There have been major developments in healthcare services as well as changes in demographics in recent years, and this has, among other things, led to increased demand for ambulance services. In general, this ...

Authors: Sveinbjörn Dúason, Christoffer Ericsson, Hrafnhildur Lilja Jónsdóttir, Jeanette Viggen Andersen and Thomas Lynge Andersen

The definition of major trauma using different revisions of the abbreviated injury scale

A threshold Injury Severity Score (ISS) ≥ 16 is common in classifying major trauma (MT), although the Abbreviated Injury Scale (AIS) has been extensively revised over time. The aim of this study was to determi...

Authors: Jan C. Van Ditshuizen, Charlie A. Sewalt, Cameron S. Palmer, Esther M. M. Van Lieshout, Michiel H. J. Verhofstad and Dennis Den Hartog

Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: a systematic review

Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) increases neurologically intact survival in out-of-hospital cardiac arrest (OHCA) according to several studies. This systematic review summarizes neur...

Authors: Kristine Elisabeth Eberhard, Gitte Linderoth, Mads Christian Tofte Gregers, Freddy Lippert and Fredrik Folke

Systems for recognition and response to deteriorating emergency department patients: a scoping review

Assessing and managing the risk of clinical deterioration is a cornerstone of emergency care, commencing at triage and continuing throughout the emergency department (ED) care. The aim of this scoping review w...

Authors: Julie Considine, Margaret Fry, Kate Curtis and Ramon Z. Shaban

Smartphone-based dispatch of Community First Responders in the United Kingdom

Authors: Adam James Rae Watson

Relationship between admission coagulopathy and prognosis in children with traumatic brain injury: a retrospective study

Coagulopathy in adult patients with traumatic brain injury (TBI) is strongly associated with unfavorable outcomes. However, few reports focus on pediatric TBI-associated coagulopathy.

Authors: Cheng-yan You, Si-wei Lu, Yue-qiang Fu and Feng Xu

Randomised controlled trials in pre-hospital trauma: a systematic mapping review

Trauma is a leading cause of morbidity and mortality worldwide with about 5.8 million deaths globally and the leading cause of death in those aged 45 and younger. The pre-hospital phase of traumatic injury is ...

Authors: Matilda K. Björklund, Moira Cruickshank, Robbie A. Lendrum and Katie Gillies

Rapid sequence induction: where did the consensus go?

Rapid Sequence Induction (RSI) was introduced to minimise the risk of aspiration of gastric contents during emergency tracheal intubation. It consisted of induction with the use of thiopentone and suxamethoniu...

Authors: Pascale Avery, Sarah Morton, James Raitt, Hans Morten Lossius and David Lockey

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